Retinal detachment in UGH Syndrome after cataract surgery

Purpose: To report a case of retinal detachment (RD) in a UGH Syndrome after cataract surgery and to emphasize special aspects of the management, along with factors that must be considered.

Methods: We present the case of a 56-year-old man who underwent cataract surgery with a capsulorhexis leak, but the implantation of the lens in the sac did not hinder. 8 months after surgery, he presented several episodes of hypertensive uveitis that produced a progression in the excavation of the optic nerve head from 3/10 to 9/10 despite the treatment with ocular hypotensive drugs. He went to the emergency department due to sudden loss of vision during which a complete hemovitreous with a zone of transillumination and atrophy of the temporal sector of the iris were observed. Echo-B showed inferior retinal detachment. The apposition of the intraocular lens over the temporal region of the iris was observed in anterior segment OCT. Scleral band pars plana vitrectomy surgery was performed.

Results: Currently, the VA RE was 6/10 with controlled IOP without the need for treatment, the excavation was 9/10 and it preserved an island of inferior paracentral vision in the perimetry. Vitrectomy favored the posterior displacement of the lens, avoiding friction of the iris, thus eliminating outbreaks of hypertensive uveitis.

Conclusions: It is important to be aware of the mechanisms of uveitis-glaucoma-hyphema (UGH) syndrome. It is necessary to identify postoperative signs to make a diagnosis as soon as possible. It is time to consider that UGH syndrome can be caused by any type of pseudophakic lens.