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Article
March 1979

Choroidal Effusion During Glaucoma Surgery in Patients With Prominent Episcleral Vessels

Author Affiliations

From the Glaucoma Consultation Service, Massachusetts Eye and Ear Infirmary (Drs Bellows and Hutchinson), and the Howe Laboratory of Ophthalmology, Harvard Medical School (Drs Chylack and Epstein), Boston.

Arch Ophthalmol. 1979;97(3):493-497. doi:10.1001/archopht.1979.01020010243011
Abstract

• Rapid intraoperative choroidal effusion and flattening of the anterior chamber occurred during glaucoma filtering surgery in four young patients with prominent episcleral vessels, elevated episcleral venous pressure, and advanced openangle glaucoma. Two of these four patients had Sturge-Weber syndrome. Intraoperative release of suprachoroidal fluid (SCF) through a posterior sclerotomy facilitated reformation of the anterior chamber and repositioning of the iris and ciliary body. Posterior sclerostomy performed prior to opening the anterior chamber minimized the above-mentioned untoward series of events. Analysis of SCF and serum demonstrated considerable differences in total protein and individual immunoglobulin levels; this appears to be a manifestation of molecular sieving at the level of the choriocapillaris. Choroidal detachment and postoperative serous retinal detachment are manifestations of this phenomenon.

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