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Aqueous misdirection following pars plana vitrectomy and silicone oil injection

Authors Hamdy Ghoraba H, Ghali A, Mansour H

Received 30 January 2015

Accepted for publication 10 March 2015

Published 20 May 2015 Volume 2015:9 Pages 903—906


Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 4

Editor who approved publication: Dr Scott Fraser

Hammouda H Ghoraba,1,2 Ali Ahmed Ghali,3 Hosam Othman Mansour2,3

1Tanta University, Tanta, Egypt; 2Magrabi Eye Hospital, Cairo, Egypt; 3Al-Azhar University, Cairo, Egypt

Purpose: To report a retrospective series of seven phakic eyes of seven patients suffering from a malignant glaucoma-like syndrome following pars plana vitrectomy and silicone oil (SO) injection.
Materials and methods: Seven eyes with retinal detachment treated with pars plana vitrectomy with or without scleral buckling with SO tamponade. This was followed by cataract extraction to manage the elevated intraocular pressure (IOP).
Results: This was a retrospective review of seven cases that received pars plana vitrectomy and SO with or without scleral buckling for different causes of retinal detachment (three were rhegmatogenous and four were tractional). After a period ranging from 1 week to 1 month, they presented with malignant glaucoma-like manifestations; high IOP, shallow axial anterior chamber, and remarkable decrease of visual acuity. Atropine eye drops and anti-glaucoma medical treatment (topical and systemic) had been tried but failed to improve the condition. Dramatic decrease of IOP and deepening of the axial anterior chamber was observed in all cases in the first postoperative day after phacoemulsification and posterior chamber foldable intraocular lens implantation with posterior capsulotomy.
Conclusion: Aqueous misdirection syndrome may be observed following pars plana vitrectomy and SO tamponade. This must be differentiated from other causes of post vitrectomy glaucoma. Cataract extraction with posterior capsulotomy controls the condition.

Keywords: malignant glaucoma, pars plana vitrectomy, silicone oil

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