Etiology and management of uveitis-glaucoma-hyphema syndrome: a comprehensive review.

Abstract

The uveitis-glaucoma-hyphema (UGH) syndrome, initially described in 1978, presents as an iatrogenic complication associated with contact between intraocular implant and ocular tissue. This syndrome encompasses a spectrum of clinical manifestations, including intraocular inflammation, elevated intraocular pressure, and recurrent hemorrhage. Advances in cataract surgery techniques reduced the incidence of early intraocular lens (IOL) dislocation while inversely increased rates of delayed dislocation. The primary etiology of UGH syndrome is IOL subluxation. Weakness of the ciliary zonules or unstable IOL fixation techniques may predispose the eye to iris-lens contact. Other contributing factors include Soemmering's ring formation, abnormal iris and ciliary body anatomy, positional changes, and improper positioning of glaucoma implants. Clinical examination and imaging modalities such as ultrasound biomicroscopy and anterior segment optical coherence tomography supports diagnosis of UGH. Treatment options range from observation and medical therapies to invasive procedures such as laser therapy, IOL repositioning, or replacement. Endoscopy provides direct visualization for identifying causes intraoperatively, aiding in tailored surgical approaches towards minimal intervention. In conclusion, UGH syndrome poses a complex clinical challenge, emphasizing the importance of understanding its etiology, accurate diagnosis, and personalized management strategies to mitigate its impact on visual function and ensure favorable outcomes.