Successful Pars Plana Vitrectomy with Zonulo-hyaloidectomy Performed 4 Years after the Onset of Chronic Low-Grade Aqueous Misdirection
Bibliographic record
Abstract
In aqueous misdirection, the interval between diagnosis and surgical intervention is inversely proportional to the success of the surgery. Here, we report a successful outcome of pars plana vitrectomy (PPV) with irido-zonulo-hyaloidectomy 4 years after the onset of the disease. A 34-year-old female, known to have primary angle closure glaucoma, underwent trabeculectomy with mitomycin C in the right eye for uncontrolled intraocular pressure (IOP). Six weeks after the surgery, the patient presented with a shallow anterior chamber centrally and peripheral iridocorneal touch along with a patent peripheral iridectomy. Ultrasound biomicroscopy showed a shallow AC centrally with peripheral iridocorneal touch, and the ciliary body was rotated forward confirming the diagnosis of aqueous misdirection. The patient refused surgical management and was managed medically, which was unsuccessful. Four years after the diagnosis, the patient underwent PPV with irido-zonulo-hyaloidectomy because of progressive shallowing of the AC and corneal edema. One month postoperatively, visual acuity improved from 20/200 to 20/60, and the AC maintained appropriate depth. In conclusion, PPV with irido-zonulo-hyaloidectomy may result in a complete resolution of a chronic low-grade form of aqueous misdirection.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.002 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.002 | 0.002 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".