New surgical approach in the management of pseudophakic malignant glaucoma.
OBJECTIVE
To describe a new surgical approach in the management of pseudophakic malignant glaucoma.


METHODS
Noncomparative case series.


METHODS
Five consecutive patients with pseudophakic malignant glaucoma.


METHODS
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.


METHODS
Medications, visual acuity, intraocular pressure, and anterior and posterior segment findings were recorded before and after surgery.


RESULTS
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.


CONCLUSIONS
Zonulo-hyaloido-vitrectomy via the anterior segment appears to be an alternative option in the treatment of patients with pseudophakic malignant glaucoma.
Lois
N
N
The Vitreo-Retinal Service, Ophthalmology Department, The Royal Liverpool University Hospital, Liverpool, England, United Kingdom. noemilois@aol.com
Wong
D
D
Groenewald
C
C
D000368:Aged; D000369:Aged, 80 and over; D000869:Anterior Eye Segment / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D005901:Glaucoma / Q000209:etiology / Q000601:surgery*; D006801:Humans; D007429:Intraocular Pressure; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D019591:Pseudophakia / Q000150:complications / Q000601:surgery*; D016896:Treatment Outcome; D014792:Visual Acuity; D014821:Vitrectomy / Q000379:methods*