Angle-closure glaucoma associated with occult annular ciliary body detachment.
OBJECTIVE
To evaluate the role of annular ciliary body detachment in the development of postoperative angle-closure glaucoma.


METHODS
Case series.


METHODS
Tertiary care glaucoma referral center.


METHODS
High-resolution, anterior segment ultrasound biomicroscopy, ophthalmoscopy, and B-scan ultrasonography were performed on 6 eyes of 6 patients with a clinical diagnosis of postoperative malignant glaucoma.


RESULTS
Each eye had an elevated intraocular pressure, a shallow anterior chamber, 1 or more patent iridectomies, and no ophthalmoscopic or B-scan ultrasound evidence of serous or hemorrhagic ciliochoroidal detachment. Ultrasound biomicroscopy revealed annular ciliary body detachment in each eye. In 4 eyes, observation with topical medical treatment was associated with deepening of the anterior chamber, reduced intraocular pressure, and resolution of the detachment. Drainage of the supraciliary fluid was performed in 2 eyes.


CONCLUSIONS
Occult, annular, serous detachment of the ciliary body may cause postoperative angle-closure glaucoma. This entity is clinically indistinguishable from malignant glaucoma. Ultrasound biomicroscopy facilitates the diagnosis.
Liebmann
J M
JM
Department of Ophthalmology, The New York Eye and Ear Infirmary, New York City, NY 10003, USA.
Weinreb
R N
RN
Ritch
R
R
D000368:Aged; D000867:Anterior Chamber / Q000000981:diagnostic imaging; D002924:Ciliary Body / Q000000981:diagnostic imaging / Q000187:drug effects / Q000473:pathology*; D005260:Female; D015812:Glaucoma, Angle-Closure / Q000150:complications / Q000000981:diagnostic imaging / Q000209:etiology* / Q000601:surgery; D006801:Humans; D007429:Intraocular Pressure; D007498:Iris / Q000601:surgery; D008297:Male; D009887:Ophthalmoscopy; D012422:Rupture, Spontaneous / Q000150:complications / Q000000981:diagnostic imaging / Q000188:drug therapy; D014130:Trabeculectomy; D014463:Ultrasonography; D014603:Uveal Diseases / Q000150:complications* / Q000000981:diagnostic imaging / Q000188:drug therapy