A 78-year-old woman, aphakic of both eyes after undergoing cataract surgery twenty years earlier, who developed secondary right eye glaucoma (OD).
Because of the lack of control of the intraocular pressure with medical treatment, it was decided to implant an Ahmed valved drainage device with a sclera patch covering the extraocular trajectory of the anterior chamber.
Post-operative recovery was favorable.
Postoperative visual acuity (VA) was 0.5 in RE and 0.2 in left eye (LE).
Intraocular pressure in RE was 12 mmHg in treatment with brimonidine tartrate 0.2%.
The valve body was located in the superior temporal quadrant and the ampoule was wide and with walls.
The tube was placed in an anterior chamber and free of vitreous.
He came to the emergency room nine months after surgery and was diagnosed with acute conjunctivitis in the right eye. Treatment was established with hygienic measures and tobramycin eye drops of Tobramycin 1 drop / 8 hours solution (
0.3%; Alcon Cusi; Barcelona; Spain) artificial prescriptions on demand.
Four days later, the patient came for review presenting a VA of hand movement.
Hyperemia 3-4 +, blebitis, no seidel, diffuse corneal oedema 3+, tyndall 4+, fibrin plastron in anterior chamber, no hypopion was present in the bio Hgmic.
The conjunctive that received the tube and the capsule seemed intact.
The eye fundus was not visualized by media opacity.
Ultrasound showed low density echoes with no signs of retinal detachment.
ceftazidime and vancomycin colic from a late acute endophthalmitis, it was decided to initiate the existing protocol in the hospital, obtaining aqueous and vitreous humor samples, and intravenous ceftazidime
After 48 hours, the culture result was Haemophilus influenzae resistant to vancomycin and sensitive to beta-lactams, quinolones, quinolones, new topical rifampin, quinolone injection and vancomycin was suspended.
At 72 hours, due to the poor evolution, it was decided to remove the drainage device, wash the anterior chamber, and inject ceftazidime subconjunctival and intravitreal.
Poor viewing of patients with dementia is a common practice of hysterectomy.
Four days later, the VA was of no light perception, so it was decided to perform the procedure.
