Introduction: Uveitis–glaucoma–hyphema (UGH) syndrome is a complication of cataract surgery due to iris chafing by a displaced intraocular lens (IOL). This case describes an inconspicuous presentation of UGH, in which diagnosis was aided by surgical endoscopic examination, a technique rarely described in the literature thus far. Patient and Clinical Findings: A 70-year-old woman presented with recurrent anterior uveitis, ocular hypertension, and iris abnormalities in the left eye. As her symptoms started after cataract extraction, there was concern for an IOL-induced uveitis. Results of slitlamp examination, gonioscopy, and ultrasound biomicroscopy (UBM) were indeterminant. Diagnosis, Intervention, and Outcomes: The patient elected for surgical endoscope evaluation of the inserted IOL, which revealed the superonasal haptic extending through a focal posterior capsular tear, with the terminal arm then resting on the anterior lens capsule against the posterior iris. The IOL was removed, and the patient was left aphakic. There has been no recurrence of uveitis now 26-month post-IOL removal. Conclusions: UGH is often difficult to diagnose, and obvious lens dislocation may not be seen with UBM or gonioscopy. Surgical endoscopy can be used in these cases to confirm the diagnosis.
Mayeda et al. (Thu,) studied this question.