title: 25-Gauge pars plana vitrectomy for ciliary block (malignant) glaucoma.
abstract: To evaluate the efficacy of 25-ga pars plana vitrectomy (PPV) and 25-ga PPV combined with phacoemulsification surgery for managing ciliary block (malignant) glaucoma. The medical records of 11 eyes, in nine consecutive patients with malignant glaucoma were retrospectively reviewed to determine the efficacy of 25-ga PPV for alleviating this disease. All phakic eyes underwent phacoemulsification surgery during vitrectomy. Control of intraocular pressure (IOP), pre- and postoperative best-corrected visual acuity (BCVA), and development of intra- and postoperative complications were evaluated during follow-up. Malignant glaucoma was promptly resolved, and recurrence was not observed during a mean follow-up period of 12.7 ± 3.2 (range 6-18) months. The mean IOP decreased from 35.9 ± 2.9 mmHg, preoperatively, to 16.0 ± 1.4 mmHg, measured at last visit (P = 0.013). Although IOP control was achieved in all eyes after surgery, two eyes required long-term topical antiglaucoma medication. The mean logarithm of the minimum angle of resolution BCVA improved from +0.69 ± 0.11, preoperatively, to +0.29 ± 0.07, postoperatively (P = 0.027). No severe intraoperative complications were observed. Postoperative complications mostly occurred during the first week after surgery, including transient corneal edema and Descemet's membrane folds in three eyes, fibrotic exudation in 2, local iris posterior synechia in 1, and transient hypotony in 1, which were resolved spontaneously or with medication. The 25-ga PPV procedure seems to be safe and effective for treating malignant glaucoma. Combined vitrectomy with phacoemulsification surgery and a staged surgical approach may improve the success rate.
authors: Beijing Tong Ren Hospital, Capital Medical University, Beijing, 100730, China.
authors: Li
authors: L
authors: Meng
authors: Wenbin
authors: W
authors: Wei
authors: Yanlong
authors: Y
authors: Li
authors: Xiaoying
authors: X
authors: Hui
authors: Xiaodong
authors: X
authors: Han
authors: Xiaobo
authors: X
authors: Shi
mesh_terms: D000328:Adult; D000368:Aged; D002829:Choroid / Q000601:surgery; D005134:Eye Neoplasms / Q000150:complications*; D005260:Female; D005901:Glaucoma / Q000209:etiology / Q000601:surgery*; D006801:Humans; D007429:Intraocular Pressure; D007431:Intraoperative Complications; D019654:Lens Implantation, Intraocular / Q000379:methods; D008297:Male; D008875:Middle Aged; D018918:Phacoemulsification / Q000379:methods; D012189:Retrospective Studies; D014792:Visual Acuity; D014821:Vitrectomy / Q000379:methods*