Late-Onset Isolated Vitreous Hemorrhage After Micropulse Transscleral Cyclophotocoagulation: A Case Report and Insights for a Rare Complication

Wisam Shihadeh,1 Abdelwahab Aleshawi,1 Yara Aburamadan,2 Mohammed Al-Shalakhti,3 Amr Abu Najm,1 Ala’ Y’ Ibrahim3 1Division of Ophthalmology, Department of Special Surgery, Faculty of Medicine, Jordan University of Science and Technology, Irbid, 22110, Jordan; 2University College London, Hospital NHS Trust, London, UK; 3Faculty of Medicine, Yarmouk University, Irbid, 21163, JordanCorrespondence: Wisam Shihadeh, Division of Ophthalmology, Department of Special Surgery, Faculty of Medicine Jordan University of Science and Technology, P. O. Box: 3030, Irbid, 22110, Jordan, Tel +962 79 5821582, Email [email protected]: Micropulse transscleral diode cyclophotocoagulation (MP-TSCPC) has been developed as an alternative and safer approach to cyclodestructive procedures. While MP-TSCPC has an improved safety profile, reported complications of this procedure, though uncommon, include anterior chamber inflammation, mydriasis, hypotony, macular edema, corneal edema, phthisis bulbi, vitreous hemorrhage (VH), and conjunctival hemorrhage.Case Presentation: We report a case of a 76-year-old male who underwent uneventful MP-TSCPC for the left eye due to moderate primary-open angle glaucoma. A few days following the procedure, dense VH developed without hyphema or suprachoroidal hemorrhage. The VH persisted despite observation, and pars plana vitrectomy was performed, the patient recovered quickly, and achieved a visual acuity of 6/12 with an intraocular pressure of 10 mmHg.Conclusion: MP-TSCPC is considered a safe and effective procedure in glaucoma management. However, the treating ophthalmologist should always be aware of rare but potentially serious complications. In our case report, we report a case of dense VH without hyphema or suprachoroidal hemorrhage following MP-TSCPC.Keywords: micropulse transscleral diode cyclophotocoagulation, vitreous hemorrhage, glaucoma, intraocular pressure