Dr. Pallavi Sinha, S07550, Dr. Shalabh Sinha
A 55 year old diabetic female patient presented with diminished vision in both the eyes. She had counting finger close to face vision in right eye and NPL in left eye. Both eyes were found to have corneal haze with a very shallow anterior chamber, semi dilated pupils and nuclear sclerosis.
IOP was 55mmHg in right eyes and not recordable in left eye. Disc showed a 0.9 cupping in right eye and optic atrophy in left eye. Intravenous mannitol was administered followed by oral and topical anti glaucoma drugs. 10 days later the IOP remained the same and she was offered cataract extraction with trabeculectomy and IOL implantation in her right eye.
Pre-operatively she refused intravenous mannitol. An innovative alternative was planned. 27 gauge cannula was inserted 4mm from limbus in the inferotemporal quadrant and infusion was placed in anterior chamber. Vitrectomy was done behind the lens and the anterior chamber deepened. This was followed by successful completion of surgery as planned.