“Snuff” Phenomenon after Glaucoma Surgery: A Case Report
Daniel Laroche* and Oluwatosin Omilabu
ABSTRACT
Purpose: To report a rare case of severe central vision loss (“snuff-out phenomenon”) following glaucoma surgery in a 79-year-old male with advanced glaucoma.
Observations: A 79-year-old Black male with advanced primary open-angle glaucoma and a history of poor medication compliance underwent Ahmed Valve FP-7 implantation with ciliary sulcus placement. Postoperative challenges included hyphema, IOP spikes, and eventual severe central vision loss in the operated eye, even after achieving target IOP with medical and surgical management. Contributing factors included advanced glaucomatous damage, corneal scarring, and poor adherence to treatment prior to surgery. No other causes, such as tube obstruction or macular changes, were identified.
Conclusions: Severe central vision loss after glaucoma surgery is rare but can occur, especially in patients with advanced disease. Risk factors such as advanced optic nerve damage, IOP fluctuations, and poor preoperative compliance may increase susceptibility. Early surgical intervention for mild-tomoderate glaucoma could potentially reduce the frequency of advanced disease and its associated complications. Careful perioperative planning and close postoperative follow-up are critical to minimizing this risk.
