DR. PRASANNA VENKATESH RAMESH

DR. R. RAMESH, DR. SATHYAN PARTHASARATHY, DR. SHRUTHY VAISHALI RAMESH

Abstract

Axenfeld-Rieger syndrome (ARS) is a rare disease characterised by anterior segment anomalies with or without glaucoma. A 28-year-old antenatal woman diagnosed with ARS presented with uncontrolled intraocular pressures (IOPs) and advanced glaucoma despite maximal medical therapy and progressive vision loss during her third trimester. The refractory and progressive nature of glaucoma with useful vision in one eye necessitated immediate surgical intervention. After obstetric consultation, Ahmed glaucoma drainage device (GDD) was implanted in OD under sub tenon’s anaesthesia with foetal monitoring in a facility, where obstetric emergency services was within reach, after weighing risks to both mother and child. Following the GDD implantation, there was successful control of the IOP, lasting till final follow-up period of 18 months. In this paper, we discuss role of glaucoma surgery, for ARS patient with refractory glaucoma, during the third trimester with comprehensive review of literature.