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    The hyphema that keeps on giving

    Challenging glaucoma patient leads to a range of methods to stop bleeding



    Progress was slow to nil so a retinal surgeon was consulted. He recommended clearing the clot by pulling it from the eye. After pulling on the clot with forceps, “the hyphema that keeps on giving” started, Dr. Giaconi said.

    “There was a lot of blood emanating into the chamber, most likely from the area with the regressed tumor,” she added.

    Anterior vitrectomy was recommenced but “the visibility was poor because every time eye pressure went down, blood came in,” she said.

    Multiple instruments were tried, additional incisions were made to approach the clot from different angles, and additional manipulation of the vitrector settings were made.  About 1½ hours into the case, the visual axis was cleared and the inferonasal tube shunt was visualized.

    “The problem was, I didn’t feel like I could stop here because I knew bleeding would continue and negate all the progress I’d painfully made,” Dr. Giaconi said.


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