Uveitis-Glaucoma-Hyphema Syndrome Secondary to Asymmetric Intraocular Lens (IOL) Haptic Fixation: A Clinical Lesson in Mechanism-Based Diagnosis and Treatment.

Uveitis-glaucoma-hyphema (UGH) syndrome is a rare complication of cataract surgery caused by mechanical chafing between the intraocular lens (IOL) and adjacent uveal structures. We report a case of UGH syndrome caused by inadvertent sulcus placement of an IOL haptic. An 80-year-old man developed progressive ocular hypertension after apparently uncomplicated cataract surgery and was treated with topical antiglaucoma therapy. Approximately 30 months after cataract surgery, hyphema and decreased vision occurred, and the patient was referred to our institution. Slit-lamp examination showed mild nasal IOL decentration, while gonioscopy revealed marked inferior angle pigmentation. Anterior segment optical coherence tomography (AS-OCT) demonstrated IOL tilt and contact between the posterior iris surface and the nasal haptic. The patient underwent repositioning of the displaced haptic into the capsular bag, combined with Ahmed glaucoma valve implantation and pars plana tube insertion. After surgery, AS-OCT confirmed resolution of iris-IOL contact, and intraocular pressure was well controlled. This case may serve as a lesson for residents and young ophthalmologists who may encounter ocular hypertension of unclear origin, emphasizing the need to maintain a high index of suspicion for UGH syndrome. Careful anterior segment examination, together with AS-OCT, may help identify occult iris-IOL chafing and guide appropriate surgical management.