Aqueous misdirection syndrome

Summary of Evidence

Surgical management

Pars plana vitrectomy achieved anatomical success in 90% and functional success in 78% in a case series of 69 eyes with refractory aqueous misdirection syndrome syndrome. {Al Bin Ali GY, Al-Mahmood AM, Khandekar R, Abboud EB, Edward DP, Kozak I. OUTCOMES OF PARS PLANA VITRECTOMY IN THE MANAGEMENT OF REFRACTORY AQUEOUS MISDIRECTION SYNDROME. Retina. 2017 Oct;37(10):1916-1922.}

Evidence

1. Background

2. Laser treatment

2.1 Posterior capsulotomy and hyaloidotomy

Case series

1991 Melamed et.al.

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1991
Case series

Nd-YAG laser hyaloidotomy employed successfully in 3 patients with malignant glaucoma, though several sessions required. {Melamed S, Ashkenazi I, Blumenthal M. Nd-YAG laser hyaloidotomy for malignant glaucoma following one-piece 7 mm intraocular lens implantation. Br J Ophthalmol. 1991 Aug;75(8):501-3.}

2.2 Transcleral Cyclophotocoagulation

Case series

2008 Stumpf et.al.

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2008
Case series

Transscleral cyclodiode laser photocoagulation was successful in 5 patients with refractory aqueous misdirection syndrome {Stumpf TH, Austin M, Bloom PA, McNaught A, Morgan JE. Transscleral cyclodiode laser photocoagulation in the treatment of aqueous misdirection syndrome. Ophthalmology. 2008 Nov;115(11):2058-61.}

3. Surgical treatment

3.1 Core Vitrectomy

Case series

2021 Raj et.al.

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2021
Case series

Pars plana vitrectomy-hyaloidotomy-zonulectomy-iridotomy was used in 12 out of 15 eyes that underwent treatment of malignant glaucoma with complete success. {Raj S, Thattaruthody F, Joshi G, Seth NG, Kaushik S, Pandav SS. Treatment outcomes and efficacy of pars plana vitrectomy-hyaloidotomy-zonulectomy-iridotomy in malignant glaucoma. Eur J Ophthalmol. 2021 Jan;31(1):234-239.}

Case series

2017 Al Bin Ali et.al.

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2017
Case series

Pars plana vitrectomy achieved anatomical success in 90% and functional success in 78% in a case series of 69 eyes with refractory aqueous misdirection syndrome syndrome. {Al Bin Ali GY, Al-Mahmood AM, Khandekar R, Abboud EB, Edward DP, Kozak I. OUTCOMES OF PARS PLANA VITRECTOMY IN THE MANAGEMENT OF REFRACTORY AQUEOUS MISDIRECTION SYNDROME. Retina. 2017 Oct;37(10):1916-1922.}

References

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