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      A Rare Case of Postoperative Uveitis and Obstructive Peripheral Anterior Synechiae Following Combined OMNI Canaloplasty and Hydrus Microstent Implantation

      case-report

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          ABSTRACT

          Purpose

          This study seeks to highlight and explore the occurrence of uveitis with obstructive peripheral anterior synechiae (PAS) after a combined OMNI canaloplasty and Hydrus microstent implantation with phacoemulsification, particularly in a patient with a background of psoriatic arthritis.

          Observations

          A 56-year-old male with a medical history of psoriatic arthritis (in remission for 10 years) and primary open-angle glaucoma (POAG) underwent a combined OMNI canaloplasty and Hydrus microstent with phacoemulsification. The surgical procedure was uncomplicated. However, within 2 weeks postsurgery, the patient presented with severe symptoms, including uveitis, elevated intraocular pressure (IOP), and a significant reduction in best-corrected visual acuity (BCVA). This postoperative response was unexpected, especially given the lack of any past history of uveitis in the patient. The complication, potentially influenced by the patient's history of psoriatic arthritis, led to the need for additional interventions, including the implantation of an Ahmed glaucoma valve.

          Conclusion

          This case underscores the potential for postoperative complications, specifically uveitis with obstructive PAS, following combined OMNI canaloplasty and Hydrus microstent with phacoemulsification, especially in patients with a history of autoimmune diseases. Careful preoperative history, postoperative monitoring, and a nuanced approach to surgical planning are crucial. The association between systemic inflammatory conditions and ocular complications warrants deeper exploration to ensure optimal patient care.

          How to cite this article

          Dossantos J, An J. A Rare Case of Postoperative Uveitis and Obstructive Peripheral Anterior Synechiae Following Combined OMNI Canaloplasty and Hydrus Microstent Implantation. J Curr Glaucoma Pract 2024;18(1):37–41.

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          Most cited references15

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          A look at autoimmunity and inflammation in the eye.

          Autoimmune and inflammatory uveitis are a group of potentially blinding intraocular inflammatory diseases that arise without a known infectious trigger and are often associated with immunological responses to unique retinal proteins. In the United States, about 10% of the cases of severe visual handicap are attributed to this group of disorders. As I discuss here, experimental models of ocular autoimmunity targeting retinal proteins have brought about a better understanding of the basic immunological mechanisms involved in the pathogenesis of uveitis and are serving as templates for the development of novel therapies.
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            A Randomized Trial of a Schlemm's Canal Microstent with Phacoemulsification for Reducing Intraocular Pressure in Open-Angle Glaucoma.

            To assess the safety and effectiveness of the Hydrus Microstent (Ivantis, Inc, Irvine, CA) with concurrent cataract surgery (CS) for reducing intraocular pressure (IOP) in open-angle glaucoma (OAG).
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              • Record: found
              • Abstract: found
              • Article: not found

              A Schlemm Canal Microstent for Intraocular Pressure Reduction in Primary Open-Angle Glaucoma and Cataract

              To compare cataract surgery with implantation of a Schlemm canal microstent with cataract surgery alone for the reduction of intraocular pressure (IOP) and medication use after 24 months.
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                Author and article information

                Journal
                J Curr Glaucoma Pract
                J Curr Glaucoma Pract
                JOCGP
                Journal of Current Glaucoma Practice
                Jaypee Brothers Medical Publishers
                0974-0333
                0975-1947
                Jan-Mar 2024
                : 18
                : 1
                : 37-41
                Affiliations
                [1 ]Department of Ophthalmology, GW School of Medicine and Health Sciences (SMHS), Washington, DC, State of Washington, United States of America
                [2 ]Department of Ophthalmology, Wilmer Eye Institute, Johns Hopkins School of Medicine, Baltimore, Maryland, State of Washington, United States of America
                Author notes
                Jason Dossantos, Department of Ophthalmology, GW School of Medicine and Health Sciences (SMHS), Washington, DC, State of Washington, United States of America, Phone: +1 240 482 1100, e-mail: jdossantos@ 123456gwu.edu
                Article
                10.5005/jp-journals-10078-1436
                10997961
                38585161
                8811e28c-ab7e-46bb-933f-5ae5f076f9f1
                Copyright © 2024; The Author(s).

                © The Author(s). 2023 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( https://creativecommons.org/licenses/by-nc/4.0/), which permits unrestricted use, distribution, and non-commercial reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                : 01 March 2024
                : 27 March 2024
                : 30 March 2024
                Categories
                Case Report

                case report,hydrus microstent,obstructive peripheral anterior synechiae,omni canaloplasty,phacoemulsification,psoriatic arthritis,uveitis

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