Panscleritis as an Unusual Complication of Gonioscopy-assisted Transluminal Trabeculotomy

J Glaucoma. 2019 Feb;28(2):e21-e23. doi: 10.1097/IJG.0000000000001100.

Abstract

Purpose: The main purpose of this study was to report a case of panscleritis after gonioscopy-assisted transluminal trabeculotomy (GATT).

Methods: We describe the case of a 33-year-old man with a history of unilateral anterior uveitis and glaucoma, who developed panscleritis after GATT surgery.

Results: Uneventful GATT surgery was performed in a glaucomatous left eye. On the second postoperative day, the patient developed tenderness on palpation of the eye. Ophthalmic examination revealed significant diffuse hyperemia, elongated and tortuous upper bulbar conjunctival/scleral vessels, and exudative retinal detachment at the superior nasal quadrant, with diffuse scleral thickening. The patient was diagnosed as having panscleritis, which was attributed to the GATT surgery. Although the scleritis resolved completely with intravenous and oral methylprednisolone treatment, localized retinal detachment persisted.

Conclusions: Surgery-induced posterior scleritis may occur following minimally invasive glaucoma surgeries such as GATT. Control of uveitis for at least 3 months before surgery is indicated in patients with uveitis if GATT surgery is planned.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Anti-Allergic Agents / therapeutic use
  • Diagnostic Techniques, Surgical
  • Drug Combinations
  • Follow-Up Studies
  • Glaucoma, Open-Angle / physiopathology
  • Glaucoma, Open-Angle / surgery*
  • Glucocorticoids / therapeutic use
  • Gonioscopy*
  • Humans
  • Intraocular Pressure / physiology
  • Loteprednol Etabonate / therapeutic use
  • Male
  • Methylprednisolone / therapeutic use
  • Postoperative Period
  • Retrospective Studies
  • Scleritis / drug therapy
  • Scleritis / etiology*
  • Trabeculectomy / adverse effects*
  • Treatment Outcome
  • Visual Acuity

Substances

  • Anti-Allergic Agents
  • Drug Combinations
  • Glucocorticoids
  • Methylprednisolone
  • Loteprednol Etabonate