New surgical approach in the management of pseudophakic malignant glaucoma
Presented at XXIInd meeting of the Club Jules Gonin, Taormina, Italy, September 2000.
Received 22 June 2000; accepted 28 November 2000.
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.
Manuscript no. 200367.
aThe Vitreo-Retinal Service, Ophthalmology Department, The Royal Liverpool University Hospital, Liverpool, England, United Kingdom
bDr. Lois is now located at the Aberdeen Royal Infirmary, Ophthalmology Department, Retina Service, Foresterhill, Aberdeen, Scotland, United Kingdom
Correspondence and reprint requests to Noemi Lois, MD, PhD, Retina Service, Ophthalmology Department, Aberdeen Royal Infirmary, Foresterhill, Aberdeen AB25 2ZN, Scotland
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