N Lois1, D Wong, C Groenewald. 1. The Vitreo-Retinal Service, Ophthalmology Department, The Royal Liverpool University Hospital, Liverpool, England, United Kingdom. noemilois@aol.com
Abstract
PURPOSE: To describe a new surgical approach in the management of pseudophakic malignant glaucoma. DESIGN: Noncomparative case series. PARTICIPANTS: Five consecutive patients with pseudophakic malignant glaucoma. METHODS: All patients underwent zonulo-hyaloido-vitrectomy. The procedure involves the performance of zonulectomy, hyaloidectomy, and anterior vitrectomy (zonulo-hyaloido-vitrectomy) through a peripheral iridectomy or iridotomy via the anterior chamber. MAIN OUTCOME MEASURES: Medications, visual acuity, intraocular pressure, and anterior and posterior segment findings were recorded before and after surgery. RESULTS: Resolution of the malignant glaucoma was achieved in all cases. No recurrences were observed after a median follow-up of 5.5 months (range, 1-9 months). In one patient with extensive anterior synechiae, bleb failure occurred after the resolution of the malignant glaucoma. This patient was treated successfully with a guarded filtration procedure supplemented with 5-fluorouracil. No other complications were observed. CONCLUSIONS: Zonulo-hyaloido-vitrectomy via the anterior segment appears to be an alternative option in the treatment of patients with pseudophakic malignant glaucoma.
PURPOSE: To describe a new surgical approach in the management of pseudophakic malignant glaucoma. DESIGN: Noncomparative case series. PARTICIPANTS: Five consecutive patients with pseudophakic malignant glaucoma. METHODS: All patients underwent zonulo-hyaloido-vitrectomy. The procedure involves the performance of zonulectomy, hyaloidectomy, and anterior vitrectomy (zonulo-hyaloido-vitrectomy) through a peripheral iridectomy or iridotomy via the anterior chamber. MAIN OUTCOME MEASURES: Medications, visual acuity, intraocular pressure, and anterior and posterior segment findings were recorded before and after surgery. RESULTS: Resolution of the malignant glaucoma was achieved in all cases. No recurrences were observed after a median follow-up of 5.5 months (range, 1-9 months). In one patient with extensive anterior synechiae, bleb failure occurred after the resolution of the malignant glaucoma. This patient was treated successfully with a guarded filtration procedure supplemented with 5-fluorouracil. No other complications were observed. CONCLUSIONS: Zonulo-hyaloido-vitrectomy via the anterior segment appears to be an alternative option in the treatment of patients with pseudophakic malignant glaucoma.
Authors: S Balekudaru; N S Choudhari; P Rewri; R George; P S Bhende; M Bhende; V Lingam; G Lingam Journal: Eye (Lond) Date: 2017-03-03 Impact factor: 3.775