Question
A 75-year-old man underwent intracapsular cataract extraction 25 years ago. Approximately 15 years ago, he underwent secondary anterior chamber lens placement. Two years ago, he had a penetrating keratoplasty on this eye. Over the past year, he has had recurrent uveitis in this eye, and on evaluation, his IOP is 25 mm Hg. Gonioscopy reveals an open angle and a small hyphema. The most appropriate management of his eye would be:
| A. |
aminocaproic acid
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| B. |
topical corticosteroids
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| C. |
panretinal photocoagulation
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| D. |
surgical removal of his anterior chamber lens
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Show Answer
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Correct Answer � D
Explanation
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Answer: D) surgical removal of his anterior chamber lens
Explanation:Uveitis–glaucoma–hyphema syndrome is rarely seen today, but it was a common complication of older, rigid haptic anterior chamber lenses that suffered from poor design, poor finishing characteristics, or excessive mobility, allowing them to chafe the iris surface. Pseudophakic bullous keratopathy was also more common with these types of lenses. Modern flexible haptic anterior lenses are better tolerated and less apt to cause these complications. Therefore, because this patient’s anterior chamber lens is causing problems, it should be removed or replaced.
