Recurrent microhyphema in the pseudophakic eye.

Although painless transient obscurations of vision are usually attributed to conditions affecting the posterior segment, careful slit-lamp, gonioscopic, and angiographic evaluations may establish an anterior segment origin for these symptoms. Recurrent hyphema, an uncommon late complication following routine cataract extraction, can be caused by spontaneous rupture of incisional vessels. In pseudophakic eyes, the uveitis-glaucoma-hyphema (UGH) syndrome and intermittent visual "white out" are late complications that may necessitate removal of the implant. The authors report five patients with uncomplicated extracapsular cataract extraction and implantation of a Binkhorst biplane, two-loop, capsule-fixated lens who presented with episodes of visual white out on the basis of iris bleeding. Argon laser photocoagulation to sites of iris leakage, at points of lens iris contact, resulted in prompt cessation of bleeding. Laser treatment appears to be a safe and effective alternative to removal of an otherwise satisfactory intraocular lens.