Choroidal effusion during glaucoma surgery in patients with prominent episcleral vessels
A. R. Bellows, L. T. Chylack Jr, D. L. Epstein and B. T. Hutchinson
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 open-angle 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 manifestation of this phenomenon.
