Novel microsurgical management of uveitis-glaucoma-hyphema syndrome

Purpose To report a series of cases and microsurgical management of rarely occurring uveitis-glaucoma-hyphema (UGH) syndrome in patients with single-piece acrylic intraocular lens (IOL) placed in the capsular bag. Methods It was a series of patients with UGH syndrome induced by posterior chamber IOL/capsular bag complex instability (pseudophakodonesis), who underwent IOL fixation to the iris. Visual acuity, intraocular pressure, number of glaucoma medications and IOL status (position) were recorded by the same protocol before and 6 months after the surgical treatment. Results The case series presents three patients with UGH syndrome caused by single-piece acrylic IOL placed in-the-bag. Each patient had uneventful phacoemulsification with posterior chamber IOL implantation few years ago and pseudophakodonesis caused by weakened zonules from pseudoexfoliation with subsequent development of UGH syndrome. IOL fixation to the iris with satisfactory postoperative results was performed due to the development of UGH. Signs of syndrome did not recur 6 months after the operation. Conclusion UGH syndrome can be induced by unstable in-the-bag IOL due to zonular laxity. Depending on the severity of the syndrome, this condition can be fought by applying a minimally invasive approach-IOL suturing to the iris with direct observation under the surgical microscope precisely in the anticipated location with no or minimal pupil deformation. Symptoms of UGH did not recur due to increased stability of the IOL and, as a result of this, declined irritation of the uveal tissue.