Pars plana vitrectomy in the management of phakic and pseudophakic malignant glaucoma.
OBJECTIVE
To determine the indications for and outcome of pars plana vitrectomy in the management of phakic and pseudophakic malignant glaucoma.


METHODS
Retrospective review.


METHODS
Tertiary referral ophthalmic hospital.


METHODS
Twenty-two patients (24 eyes) who underwent pars plana vitrectomy in the management of malignant glaucoma.


RESULTS
Fourteen eyes were phakic and 10 were pseudophakic at the initial vitrectomy. The primary indication for vitrectomy was failure of other therapies. In phakic eyes, the initial vitrectomy was successful in terminating malignant glaucoma without further surgery in 7 (100%) of 7 eyes that underwent lensectomy and in 5 (71%) of 7 eyes that not did not undergo lensectomy. The primary indication for lensectomy was corneal edema caused by lens-corneal touch. In pseudophakic eyes, the initial vitrectomy was successful in 9 (90%) of 10 eyes. Removal of the intraocular lens was performed in 1 eye. Perioperative complications included transient serous choroidal detachment in 2 eyes, transient exudative retinal detachment in 1 eye, and suprachoroidal hemorrhage in 1 eye.


CONCLUSIONS
Pars plana vitrectomy is effective in treating phakic and pseudophakic malignant glaucoma. Success is contingent on establishing a pathway for aqueous flow into the anterior chamber, which usually is accompanied by intraoperative deepening of the anterior chamber. In phakic eyes, lensectomy may be considered for marked corneal edema, for dense cataract, or when the anterior chamber will not deepen during vitrectomy.
Harbour
J W
JW
Bascom Palmer Eye Institute, Department of Ophthalmology, University of Miami School of Medicine, Fla.
Rubsamen
P E
PE
Palmberg
P
P
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002387:Cataract Extraction; D005260:Female; D015812:Glaucoma, Angle-Closure / Q000601:surgery*; D005902:Glaucoma, Open-Angle / Q000601:surgery*; D006801:Humans; D007429:Intraocular Pressure; D007908:Lens, Crystalline / Q000601:surgery; D007910:Lenses, Intraocular; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D014792:Visual Acuity; D014821:Vitrectomy