Hematoma in the scleral lake: Complication of non-penetrating deep sclerectomy

Abstract

Methods:We describe 4 patients suffering from open-angle glaucoma and cataract, and one patient with secondary glaucoma after Fuchs' heterochromic uveitis. All of them underwent phacoemulsification and non-penetrating deep sclerectomy with 5-fluoracil. Two patients presented hematoma in scleral lake 24 h after surgery, other 2 of them presented it one week after the intervention, and one of them presented it 2 weeks after the surgery. The hematoma was found by gonioscopy in all cases. Moreover, all patients had elevated intraocular pressure. Result: Hematoma usually appears within 2 weeks after surgery. Goniopunctures were performed in 5 patients within 5 months of the complication. A second goniopuncture was needed for one of them. Bleb needling was made in one of them. Three of the patients required treatment with beta-blocker eye drops since intraocular pressure exceeded pre-set values. Conclusion: Hematomas in scleral lake are a rare complication that may appear within 2 weeks after non-penetrating deep sclerectomy. They may cause surgery malfunction and antihypertensive eye drops might be required for tensional control. Goniopuncture could be used for solving the complication.