Intravitreal Aflibercept treatment of anterior segment ischemia after scleral buckling surgery

This report presents a case who developed corneal edema, aqueous flare, rubeosis iridis, neovascular glaucoma due to anterior segment ischemia after scleral buckling surgery and was treated with intravitreal Aflibercept.

Anterior segment ischemia is a complication that may develop after scleral buckling surgery. The signs of anterior segment ischemia include corneal edema, aqueous flare, iris atrophy, photophobia, rubeosis iridis, neovascular glaucoma and cataract. It can be diagnosed with biomicroscopy and carotid Doppler ultrasonography. The case we present in this report was found to have signs of corneal edema, aqueous flare, rubeosis iridis and neovascular glaucoma due to anterior segment ischemia that developed after scleral buckling surgery. No pathology was found in the carotid Doppler ultrasonography. Intravitreal Aflibercept treatment was given for his left eye. During the follow-up 2 weeks later, it was found that rubeosis iridis disappeared, there were no cells in the anterior chamber and his left eye intraocular pressure was 16 mmHg. The patient was followed for 2 years. After 1 year, we performed the ekpress shunt implantation in the patient for glaucoma. Because of the same reasons, intravitreal Aflibercept treatment was given for his left eye 4 times in 2 years.