New surgical approach in the management of pseudophakic malignant glaucoma.

Abstract

To describe a new surgical approach in the management of pseudophakic malignant glaucoma. Noncomparative case series. Five consecutive patients with pseudophakic malignant glaucoma. 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. Medications, visual acuity, intraocular pressure, and anterior and posterior segment findings were recorded before and after surgery. 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. Zonulo-hyaloido-vitrectomy via the anterior segment appears to be an alternative option in the treatment of patients with pseudophakic malignant glaucoma.