Surgical Management of UGH Syndrome

Roya Garakani, DO; and Mahsaw Mansoor, MD

Eyetube

Glaucoma specialists share insights into treating uveitis-glaucoma-hyphema (UGH) syndrome, as featured in the January/February 2026 issue of Glaucoma Today. Roya Garakani, DO, recaps, “Surgical Decision-Making in Patients With UGH Syndrome,” outlining options for patients with UGH syndrome who require glaucoma surgery in addition to an IOL procedure. Then, Mahsaw Mansoor, MD, recaps, “Selecting an IOL and Fixation Technique for Patients With UGH Syndrome,” which was written with Nicole Fram, MD, and presents a case-based approach to surgical management of in-the-bag UGH syndrome secondary to dead bag syndrome.

Surprise Spikes

While rare, increases in IOP post-selective laser trabeculoplasty can occur and require prompt attention for the best long-term outcomes.

Khanh Hoang, OD

Modern Optometry

Selective laser trabeculoplasty (SLT) is a safe and effective method for lowering IOP. First introduced in 1995 and FDA approved in 2001, SLT is increasingly becoming the first-line treatment for open-angle glaucoma.1 The term “selective” refers to the laser’s precision in targeting pigmented trabecular meshwork (TM) cells while sparing adjacent nonpigmented tissue.1 Using a low-energy, frequency-doubled Q-switched Nd:YAG laser (532 nm), SLT induces a biological response that enhances aqueous outflow through the TM—achieved not by ablating tissue, but by stimulating cellular and cytokine-mediated remodeling.1 Traditionally performed by anterior segment surgeons, SLT is now being adopted by a growing number of optometrists in 11 states and counting, as the scope of practice expands.2 Despite its strong safety profile, the procedure can lead to rare complications, such as corneal haze, hyphema, and persistent inflammation.3 However, the biggest concern remains transient post-procedural IOP elevation.3 Identifying appropriate candidates for SLT is key to minimizing adverse outcomes. Although IOP spikes following SLT are rare, I recently encountered a noteworthy case featuring a significant post-laser IOP spike. Interestingly, this patient demonstrated substantial ganglion cell complex (GCC) loss in the absence of a corresponding visual field defect. This article explores the clinical course of this case and reviews the incidence, pathophysiology, risk factors, and management strategies for increases in IOP following SLT. CASE PRESENTATION A 58-year-old Asian man with a history of mild bilateral primary open-angle glaucoma was referred for a glaucoma evaluation. He had been managed with multiple IOP-lowering agents, including brimonidine tartrate 0.2%/timolol maleate ophthalmic solution 0.5% (Combigan, Allergan/AbbVie) and latanoprost ophthalmic solution 0.005% (Xalatan, Viatris). On initial examination, the patient’s BCVA was 20/20 OU and his IOP was 10 mm Hg OD and 8 mm Hg OS. Slit-lamp examination revealed periocular dermatitis localized to the right upper eyelid. Posterior segment evaluation demonstrated healthy optic nerves with cup-to-disc ratios of 0.7 OD and 0.6 OS and no other notable posterior pole pathology (Figures 1 and 2).

10 Essential Steps for Accurate Retina Surgery Coding

Keeping these in mind, practices can reduce errors, prevent denials, and maintain accurate billing.

Joy Woodke, COE, OCS, OCSR, and Matthew Baugh, MHA, COT, OCS, OCSR

Retina Today

Ensuring proper reimbursement for ophthalmic surgery demands more than simply selecting a CPT code—it requires a structured, methodical approach to coding. A consistent review process helps safeguard against denials, clarify complex billing combinations, and accurately reflect what occurred in the OR. The following example shows how to apply 10 necessary steps for successful surgical coding (Figure). Figure. Following these 10 steps can help surgeons code carefully and enjoy proper reimbursement. OPERATIVE SUMMARY The operative note describes a patient who underwent a pars plana vitrectomy (PPV) to address a dislocated posterior chamber IOL in the left eye. The IOL was split into two fragments, and during surgery, each piece was carefully elevated, cut, and removed through a clear corneal incision under the protection of viscoelastic. After clearing the posterior segment, the surgeon placed a new posterior chamber IOL. A peripheral iridotomy was created to remove residual viscoelastic, and subconjunctival injections of dexamethasone and cefazolin were administered. Step 1: Identify All Possible CPT Codes and Read Full Descriptors Using the documentation in the operative report, identify every CPT code that could apply to the documented procedures.