A novel use of the endoscopic cyclophotocoagulative probe for the management of excisional goniotomy induced chronic recurrent hyphema

Abstract

Purpose: To describe the management of a case of chronic, recurrent hyphema following excisional goniotomy with the Kahook Dual Blade. Observations: One week following uncomplicated surgery, the patient presented with eye pain, elevated intraocular pressure, and layered hyphema. The hyphema resolved with conservative measures but recurred several times with similar symptoms over the next several months. An attempt to stenose the “oozing” collector channel using the argon laser was unsuccessful. Treatment of the angle with an endoscopic semi-conductor diode laser (endoscopic cyclophotocoagulative or ECP) probe successfully altered the angle preventing further episodes of recurrent hyphema. The primary glaucoma procedure failed necessitating a filtering procedure. Conclusions and importance: Clinician should be aware of this potential complication, its treatment options, and outcomes.

Keywords

• Glaucoma
• Minimally invasive glaucoma surgery
• Excisional goniotomy
• Kahook dual blade
• Recurrent hyphema
• Endoscopic cyclophotocoagulation