J Korean Ophthalmol Soc > Volume 56(4); 2015 > Article
Journal of the Korean Ophthalmological Society 2015;56(4):643-649.
DOI: https://doi.org/10.3341/jkos.2015.56.4.643    Published online April 15, 2015.
Corneal Endothelial Cell Loss after Tube Shunt Surgery in Fuch's Heterochromic Iridocyclitis.
Jin Ah Lee, Yang Kyung Cho, Tae Yoon La, Jin A Choi
Department of Ophthalmology and Visual Science, St. Vincent's Hospital, The Catholic University of Korea College of Medicine, Suwon, Korea. jinah616@hanmail.net
푹스 홍채 이색 섬모체염 환자에서 방수유출장치 삽입술 후 발생한 각막 부전
가톨릭대학교 의과대학 성빈센트병원 안과 및 시과학교실
To report a case of corneal failure after implantation of the Ahmed glaucoma valve occurring in a patient diagnosed with Fuchs' heterochromic iridocyclitis. CASE SUMMARY: A 53-year-old male who complained of ocular pain and suddenly decreased visual acuity in his right eye visited our clinic. His visual acuity was 0.15 and intraocular pressure (IOP) was 55 mm Hg. The slit-lamp examination revealed edematous cornea, fine round or stellate keratic precipitates connected with fine filaments on the endothelium and depigmentation of the iris. The corneal endothelial cell density was 2,958 cells/mm2. There was no specific finding in his left eye. The IOP did not improve with medical treatment, therefore, an Ahmed glaucoma valve was implanted in his right eye. At every follow-up exam the tube was well positioned and the IOP was maintained between 8 and 13 mm Hg. Eight months postoperatively, the patient complained of decreased visual acuity and the cell density was decreased to 1,408 cells/mm2. Posterior subcapsular cataract opacity was observed as well as progression of depigmentation and distortion of the iris. Seventeen months after the surgery, the cell density was 700 cells/mm2. On follow-up examination, his visual acuity was decreased to FC10 cm with the cataract progressing, therefore cataract surgery was performed. One month postoperatively, his vision improved to 0.1. However, the visual acuity deteriorated due to progression of the corneal edema and penetrating keratoplasty was performed. CONCLUSIONS: Aggravation of the corneal complication after Ahmed glaucoma valve implantation should be considered in patients with Fuchs' heterochromic iridocyclitis-induced glaucoma.
Key Words: Ahmed glaucoma valve surgery;Corneal endothelial cell density;Corneal failure;Fuchs' heterochromic iridocyclitis;Uveitic glaucoma

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