Devesh K Varma1, Graham W Belovay2, Diamond Y Tam2, Iqbal Ike K Ahmed2. 1. From the University of Toronto (Varma, Belovay, Tam, Ahmed), Toronto, Trillium Health Partners (Varma, Ahmed), and Credit Valley EyeCare (Varma, Tam, Ahmed), Mississauga, Ontario, Canada. Electronic address: devesh.varma@goeyecare.com. 2. From the University of Toronto (Varma, Belovay, Tam, Ahmed), Toronto, Trillium Health Partners (Varma, Ahmed), and Credit Valley EyeCare (Varma, Tam, Ahmed), Mississauga, Ontario, Canada.
Abstract
PURPOSE: To report a series of eyes that developed malignant glaucoma after cataract surgery. SETTING: Private academic practice, Toronto, Ontario, Canada. DESIGN: Retrospective case series. METHODS: Eyes that developed malignant glaucoma after cataract surgery were treated with medical therapy. This was followed by laser iridozonulohyaloidotomy, anterior chamber reformation and intraocular lens (IOL) pushback, and finally with surgical iridozonulohyaloidovitrectomy if all other measures were unsuccessful. Refraction, intraocular pressure (IOP), gonioscopy, and anterior chamber depth (ACD) by anterior segment optical coherence tomography were analyzed before treatment and after treatment. RESULTS: The study evaluated 20 eyes of 18 female patients aged 44 to 86 years. Preoperatively, the mean refraction was +3.11 diopters (D) ± 2.89 (SD), the mean axial length was 21.30 ± 1.40 mm, and all eyes had narrow or closed angles. Malignant glaucoma was diagnosed a mean of 5.8 ± 7.1 weeks postoperatively. At diagnosis, the mean refraction was -2.15 ± 2.95 D; the mean ACD, 2.49 ± 0.72 mm; and the mean IOP, 28.3 ± 10.8 mm Hg on a mean of 1.3 ± 1.6 medications. Two eyes responded to cycloplegia, 7 to laser iridozonulohyaloidotomy, and 6 to anterior chamber reformation-IOL pushback; 5 eyes required vitrectomy. Posttreatment, the mean refraction was -0.56 ± 1.07 D; the mean ACD, 3.30 ± 0.50 mm; and the mean IOP, 14.4 ± 4.60 mm Hg on a mean of 1.2 ± 1.4 medications. Cycloplegia was discontinued in 17 eyes. CONCLUSION: Malignant glaucoma can occur after phacoemulsification and presents with myopic surprise, anterior chamber shallowing and, possibly, elevated IOP. FINANCIAL DISCLOSURE: No author has a financial or proprietary interest in any material or method mentioned.
PURPOSE: To report a series of eyes that developed malignant glaucoma after cataract surgery. SETTING: Private academic practice, Toronto, Ontario, Canada. DESIGN: Retrospective case series. METHODS: Eyes that developed malignant glaucoma after cataract surgery were treated with medical therapy. This was followed by laser iridozonulohyaloidotomy, anterior chamber reformation and intraocular lens (IOL) pushback, and finally with surgical iridozonulohyaloidovitrectomy if all other measures were unsuccessful. Refraction, intraocular pressure (IOP), gonioscopy, and anterior chamber depth (ACD) by anterior segment optical coherence tomography were analyzed before treatment and after treatment. RESULTS: The study evaluated 20 eyes of 18 female patients aged 44 to 86 years. Preoperatively, the mean refraction was +3.11 diopters (D) ± 2.89 (SD), the mean axial length was 21.30 ± 1.40 mm, and all eyes had narrow or closed angles. Malignant glaucoma was diagnosed a mean of 5.8 ± 7.1 weeks postoperatively. At diagnosis, the mean refraction was -2.15 ± 2.95 D; the mean ACD, 2.49 ± 0.72 mm; and the mean IOP, 28.3 ± 10.8 mm Hg on a mean of 1.3 ± 1.6 medications. Two eyes responded to cycloplegia, 7 to laser iridozonulohyaloidotomy, and 6 to anterior chamber reformation-IOL pushback; 5 eyes required vitrectomy. Posttreatment, the mean refraction was -0.56 ± 1.07 D; the mean ACD, 3.30 ± 0.50 mm; and the mean IOP, 14.4 ± 4.60 mm Hg on a mean of 1.2 ± 1.4 medications. Cycloplegia was discontinued in 17 eyes. CONCLUSION:Malignant glaucoma can occur after phacoemulsification and presents with myopic surprise, anterior chamber shallowing and, possibly, elevated IOP. FINANCIAL DISCLOSURE: No author has a financial or proprietary interest in any material or method mentioned.
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
Authors: Thomas S Shute; Devesh K Varma; Diamond Tam; Thomas Klein; Prima Moinul; Iqbal Ike K Ahmed; Arsham Sheybani Journal: J Ophthalmic Vis Res Date: 2019 Jan-Mar