Scleral Rupture with Uveal Prolapse Following Trivial Trauma in an Eye Previously Treated with Internal and External Cyclodestructive Procedures: A Case Report.

Abstract

BACKGROUND Scleral rupture and uveal tissue prolapse after internal and external cyclodestructive procedures are rare complications secondary to trivial trauma. Micropulse cyclophotocoagulation (MP-CPC) and ultrasound cycloplasty (UCP) are effective treatments for controlling intraocular pressure (IOP) and pain in refractory glaucoma, with few complications. This case report documents a case of scleral rupture and uveal tissue prolapse secondary to trivial trauma in an eye with a history internal and external cyclodestructive procedures. CASE REPORT A 28-year-old woman with a history of intermediate uveitis and secondary glaucoma presented to the Emergency Department with significant eye pain and decreased vision following trivial trauma to her right eye. She had undergone multiple ocular surgeries, including MP-CPC and UCP, 17 months earlier. Examination revealed a perilimbal scleral rupture extending from 2 to 5 o'clock, corneal edema, and hyphema. On the same day as the initial presentation, she underwent primary repair of the right eye. Postoperative recovery showed a gradual improvement in IOP and a stable scleral wound without a leak. CONCLUSIONS Following cyclodestructive procedures, structural weakening of the ocular wall may predispose to scleral rupture and uveal tissue prolapse, particularly in eyes with a history of inflammation or prior surgery. Although the rupture in this case was triggered by trauma, it highlights a potential indirect risk associated with such interventions.