Subconjunctival Uveal Prolapse Post Cataract Surgery Trauma
A case study of an 80-year-old female with subconjunctival uveal prolapse post cataract surgery trauma is presented. Clinical findings, management strategies, and discussion on iris prolapse in open globe injuries are detailed. Images and examination results are included.
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Presentation Transcript
Manoj Mathur E-Poster 9thAnnual State Ophthalmological Conference TOSCON 2024 12thto 14thJuly, 2024 at Katriya Hotel & Towers, Hyderabad E-poster number: EP148 Title of the E-Poster: A suture can save a patients visual future Presenting Author s Name: Dr. Mirza Mujtaba Ali Baig (Final-year resident) Co-authors: Dr. Mohammed Ather (Professor) Bhaskar Medical College
Purpose: To present a case of Subconjunctival uveal prolapse following Cataract surgery Methods: A 80-year-old female patient presented to the OPD with H/O fall on the right-side of the face associated with Diminution of vision, Brownish discoloration of the conjunctiva and sclera On Ocular examination: RE LL Ectropion was seen Sub-conjunctival hemorrhage with sub-conjunctival uveal prolapse was seen AC showed hyphema pupil was updrawn and pigment deposition was seen on IOL and PCO was noted. Retina was hazily seen but B-scan was normal. Patient was a K/C/O Hypertension and was operated two years back for HMSC(SICS was performed). Patient was given topical steroids and Antibiotics and was asked to come back after 3 days
Clinical images Uveal prolapse seen as brownish discolouration of sclera and LL Ectropion see Site of uveal prolapse prominently visible going through center through the tunnel Brownish discolouration and Sub conjunctival Hemorrhage seen
On Ocular Examination: : Examination Lids Right eye Dermatochalasis, LL Ectropion Sub conjunctival hemorrhage was seen, Brownish discolouration above the superior limbus seen Limbal Arcus Normal pattern Hyphema Mid dilated, irregular, Not RL PCIOL seen with iris pigment deposition, PCO was noted Media hazy, details were not clear Left eye Dermatochalasis LL Ectropion Quiet Conjunctiva Cornea Iris Anterior chamber Pupil Limbal Arcus Normal pattern Deep, quiet Round, regular, reacting to light PCIOL seen Lens Fundus Normal 0.3:1 CDR NRR healthy BV: Normal Foveal reflex positive
Results: This is a C/O Subconjunctival uveal prolapse of the RE secondary to trauma. Discussion: In cases of open globe injuries when there is iris prolapse, It is advised to make a paracentesis opposite to the area of the prolapse This is followed by injection of a minimal amount of a viscoelastic and gentle repositioning of the iris using an iris sweep. Injecting excessive viscoelastic can result in increased pressure and additional iris prolapse. An important point in such cases is to avoid inadvertent incarceration of the iris into the suture as well as to avoid cutting the iris, except in cases in which it is frankly necrotic or epithelialized because the iris tissue can be used for future reconstruction Repair of traumatic uveal prolapse
Conclusion: Uveal prolapse following trauma is a late post-op complication of cataract surgery. It may occur due to poor wound creation closure or absence of vault effect due to old age. Uveal prolapse into the conjunctiva can lead to serious full-fledged Endophthalmitis which may be refractory to treatment. Immediate intervention should be done and the uveal tissue should be excised and wound should be repaired with sutures to create a proper seal.
