PMC6016268_01
Slit-lamp photographs of the anterior segment OU before and after surgery.. Notes: Preoperation: (A) gross hyphema grade II OD; (B, C) eight-ball hyphema with blood-stained cornea OS. Three-day postoperation: (D-F) completely resolved hyphema OU; (E, F) the inferior blood-containing bleb with air-filled anterior chamber OS. Two-month postoperation: (G) clear anterior chamber with patent iridotomy OD; (H, I) deepened anterior chamber with resolved blood-stained cornea OS. Six-month postoperation: (J) anterior segment OD after combined phacoemulsification and 180-degree goniosynechialysis (GSL); (K) nuclear sclerosis grade 3 and inflammatory membrane obscuring the pupillary axis; (L) the nonfunctioning inferior bleb. No recurrent hyphema was found during the 6 months of follow-up.
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An 81-year-old Thai female was referred to our hospital because of gross hyphema grade II in the right eye (OD) and eight-ball hyphema with blood-stained cornea in the left eye (OS) (Figure 1A-C). The hyphema completely resolved on the following day (Figure 1D). At the 2-month follow-up (Figure 1G), BCVA was 20/100 OD with nuclear sclerosis grade 2, IOP was 10 mmHg OD with three anti-glaucoma medications and gonioscopy showed 180  peripheral anterior synechiae (PAS) on the nasal and superior angles. The hyphema completely resolved within 3 days (Figure 1E-F). Two months later, slit-lamp biomicroscopy demonstrated a deep anterior chamber and resolved corneal blood staining (Figure 1H-I). At the 6-month follow-up (Figure 1J-L), BCVA was 20/50 OD and 10/400 OS.
Gonioscopic photographs after goniosynechialysis OD showed a 360 degree open anterior chamber angle.
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Gonioscopy showed a 360  open anterior chamber angle after GSL OD (as shown in Figure 2) and a 270  open anterior chamber angle OS.