New surgical approach in the management of pseudophakic malignant glaucoma

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.