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Two cases of malignant glaucoma unresolved by pars plana vitrectomy

Authors Hosoda Y, Akagi T, Yoshimura N

Received 15 January 2014

Accepted for publication 7 February 2014

Published 2 April 2014 Volume 2014:8 Pages 677—679


Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 4

Yoshikatsu Hosoda, Tadamichi Akagi, Nagahisa Yoshimura

Department of Ophthalmology and Visual Sciences, Kyoto University Graduate School of Medicine, Kyoto, Japan

Abstract: Malignant glaucoma, which is characterized by a shallow or flat anterior chamber with high intraocular pressure, can usually be resolved by pars plana vitrectomy with anterior hyaloidectomy. We describe two cases in which malignant glaucoma was refractory to conventional treatment and complete vitrectomy. Case one an 88-year-old woman with pseudoexfoliation glaucoma underwent trabeculotomy and subsequently developed malignant glaucoma. Four months after transient recovery by pars plana vitrectomy, the malignant glaucoma recurred. She underwent peripheral iridectomy and local zonulectomy with successful control of her intraocular pressure. In case two, an 85-year-old man had a history of pseudoexfoliation glaucoma. Seven months after phacoemulsification and intraocular lens implantation, he developed malignant glaucoma that was refractory to pars plana vitrectomy. He underwent peripheral iridectomy, goniosynechialysis and trabectome surgery resulting in the successful control of his intraocular pressure. In rare cases of malignant glaucoma refractive to vitrectomy, peripheral iridectomy with or without local zonulectomy is a reasonable and minimally invasive surgical procedure.

Keywords: malignant glaucoma, pars plana vitrectomy, peripheral iridectomy

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