Abstract

The existing literature includes very few case reports of UGH with in the bag IOL. Our case is unique because of the innumerable challenges we encountered in the management of this 77 year old gentleman, which includes multiple mechanisms of glaucoma due to pseudo- exfoliation, pseudo- phacodonesis causing angle closure and UGH possibly complicated by neovascularization, very high IOP uncontrolled on medication with rapid deterioration in vision and advanced glaucoma at presentation. We performed a trabeculectomy with IOL exchange removing the bag IOL complex with Sommering's ring cataract through a 2.8 mm incision and performed a secondary IOL. The choice was CM T flex IOL which offers the advantage of being foldable and hence could be implanted through a 2.8mm incision thus sparing conjunctiva and the optic haptic angulation of 15 degrees also prevents pigment dispersion. Take home is that the UGH management is effective only when the primary cause is addressed simultaneously.