title: Outcomes of different management options for malignant glaucoma: a retrospective study.
abstract: BACKGROUND
  To assess the outcomes of the various medical and surgical treatment options for malignant glaucoma.
  
  
  METHODS
  Design Retrospective, comparative case series. Participants Twenty-four eyes of 21 patients with malignant glaucoma. Intervention Nine eyes were treated medically. Twenty-one eyes underwent surgery, 15 of which had the full vitrectomy-(phaco)-iridectomy-zonulectomy procedure. Main outcome measures Intraocular pressure (IOP), best-corrected visual acuity (BCVA) and number of glaucoma medications were measured.
  
  
  RESULTS
  The relapse rate was 100% after medical therapy, 75% after a Yag laser capsulotomy and a hyaloidotomy, 75% after a conventional vitrectomy and 66% after an anterior vitrectomy in combination with an iridectomy-zonulectomy. All patients who underwent a full vitrectomy combined with an iridectomy and a zonulectomy (and phacoemulsification if phakic) had postoperative relief of malignant glaucoma without relapse within the follow-up period. After this vitrectomy-tunnel technique, the IOP ranged from 10 to 22 mmHg (mean 16 mmHg) after a mean follow-up of 61 days. Mean BCVA improved by 5 Early Treatment Diabetic Retinopathy Study (ETDRS) lines, and mean number of glaucoma medications decreased from two to one.
  
  
  CONCLUSIONS
  Complete vitrectomy combined with iridectomy and zonulectomy (and phacoemulsification, if applicable) most successfully managed aqueous misdirection syndrome in our retrospective case series.
authors.affiliation: Department of Ophthalmology, Kapucijnenvoer 33, 3000 Leuven, Belgium.
authors.forename: Veroniek
authors.initials: V
authors.lastname: Debrouwere
authors.forename: Peter
authors.initials: P
authors.lastname: Stalmans
authors.forename: Joachim
authors.initials: J
authors.lastname: Van Calster
authors.forename: Werner
authors.initials: W
authors.lastname: Spileers
authors.forename: Thierry
authors.initials: T
authors.lastname: Zeyen
authors.forename: Ingeborg
authors.initials: I
authors.lastname: Stalmans
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D001082:Aqueous Humor / Q000378:metabolism; D002924:Ciliary Body / Q000378:metabolism; D005260:Female; D018463:Filtering Surgery; D005901:Glaucoma / Q000188:drug therapy* / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D007429:Intraocular Pressure / Q000502:physiology; D032801:Iridectomy; D053685:Laser Therapy; D053844:Lasers, Solid-State; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D012189:Retrospective Studies; D014065:Tonometry, Ocular; D016896:Treatment Outcome; D014792:Visual Acuity / Q000502:physiology; D014821:Vitrectomy
chemical_list: D000959:Antihypertensive Agents