Grazyna Malukiewicz1, Joanna Stafiej. 1. Department of Ophthalmology, Ludwik Rydygier Medical College in Bydgoszcz, Nicolaus Copernicus University in Toruń. malukiewicz@wp.pl
Abstract
PURPOSE: The purpose of this paper is to present the case of malignant glaucoma complicated by CRVO occurring after Nd: YAG laser posterior capsulotomy. MATERIAL AND METHODS: A 75 years old woman with pseudophakia and cardiovascular disease had undergone Nd: YAG laser posterior capsulotomy, the day after capsulotomy IOP increased in that eye up to 50 mmHg. Medical treatment alone appeared to be unsuccessful. IOP remained elevated (50 mmHg) and lack of anterior chamber occurred. In the examination, the eye showed circumcorneal congestion, diffuse corneal edema, uniformly flat anterior chamber with dilated, nonreacting pupil, optic disc edema, retinal hemorrhages, dilated tortuous retinal veins and macular edema. Surgical therapy (pars plana vitrectomy and the anterior chamber reformation with air bubble) was performed in urgent course. RESULTS: Twenty four hours after surgical intervention anterior chamber remained deep, IOP reduced to 12,2 mmHg, B-scan ultrasonography did not show any aqueous pockets in the vitreous. In the following 10 days, the IOP remained within normal limits with a well-formed anterior chamber. The final best-corrected visual acuity of the eye was 0.3. CONCLUSIONS: Early recognition of malignant glaucoma and proper treatment is the most important step to save the eye from severe consequences and prevent irreversible vision loss.
PURPOSE: The purpose of this paper is to present the case of malignant glaucoma complicated by CRVO occurring after Nd: YAG laser posterior capsulotomy. MATERIAL AND METHODS: A 75 years old woman with pseudophakia and cardiovascular disease had undergone Nd: YAG laser posterior capsulotomy, the day after capsulotomy IOP increased in that eye up to 50 mmHg. Medical treatment alone appeared to be unsuccessful. IOP remained elevated (50 mmHg) and lack of anterior chamber occurred. In the examination, the eye showed circumcorneal congestion, diffuse corneal edema, uniformly flat anterior chamber with dilated, nonreacting pupil, optic disc edema, retinal hemorrhages, dilated tortuous retinal veins and macular edema. Surgical therapy (pars plana vitrectomy and the anterior chamber reformation with air bubble) was performed in urgent course. RESULTS: Twenty four hours after surgical intervention anterior chamber remained deep, IOP reduced to 12,2 mmHg, B-scan ultrasonography did not show any aqueous pockets in the vitreous. In the following 10 days, the IOP remained within normal limits with a well-formed anterior chamber. The final best-corrected visual acuity of the eye was 0.3. CONCLUSIONS: Early recognition of malignant glaucoma and proper treatment is the most important step to save the eye from severe consequences and prevent irreversible vision loss.