Full-thickness Sclerotomy for Uveal Effusion Syndrome
This case involved a 46-year-old man with blurry vision in the left eye for one week. For 15 years, he had receiving treatment with an intraocular pressure lowering medication at another hospital, and he was treated at our hospital with trabeculectomy one month prior to this second presentation under the diagnosis of congenital glaucoma. The refractive error was +3.5 D bilaterally, and BCVA was 0.4 logMAR before his experience with blurred vision. The anterior segment was normal with a proper filtering bleb, but examination of the posterior segment showed a total retinal and choroidal detachment (). Retinal detachment with choroidal effusion was confirmed on ultrasound examination. The scleral thickness and axial length in the left eye measured by ultrasound were 1.94 and 22.94 mm, respectively. Treatment with oral steroids (50 mg oral prednisolone per day) was ineffective. We performed three rounds of drainage sclerotomy. Sclerotomy was performed at the superonasal and inferonasal quadrants during the first surgery. An abnormally rigid and thick sclera was observed during surgery. The first surgery resulted in recurrence of uveal effusion three days postoperatively. During the second surgery, we added two drainage sclerotomies in the same quadrants as those of the first surgery. UES recurred eight weeks postoperatively, and then a third surgery was performed in the inferotemporal quadrant. After the final surgery, the subretinal fluid gradually resolved at one month postoperatively (). The final BCVA measured one month after the last surgery was 0.02 logMAR.