title: Malignant glaucoma after cataract surgery.
abstract: OBJECTIVE
  To report a series of eyes that developed malignant glaucoma after cataract surgery.
  
  
  METHODS
  Private academic practice, Toronto, Ontario, Canada.
  
  
  METHODS
  Retrospective case series.
  
  
  METHODS
  Eyes that developed malignant glaucoma after cataract surgery were treated with medical therapy. This was followed by laser iridozonulohyaloidotomy, anterior chamber reformation and intraocular lens (IOL) pushback, and finally with surgical iridozonulohyaloidovitrectomy if all other measures were unsuccessful. Refraction, intraocular pressure (IOP), gonioscopy, and anterior chamber depth (ACD) by anterior segment optical coherence tomography were analyzed before treatment and after treatment.
  
  
  RESULTS
  The study evaluated 20 eyes of 18 female patients aged 44 to 86 years. Preoperatively, the mean refraction was +3.11 diopters (D) ± 2.89 (SD), the mean axial length was 21.30 ± 1.40 mm, and all eyes had narrow or closed angles. Malignant glaucoma was diagnosed a mean of 5.8 ± 7.1 weeks postoperatively. At diagnosis, the mean refraction was -2.15 ± 2.95 D; the mean ACD, 2.49 ± 0.72 mm; and the mean IOP, 28.3 ± 10.8 mm Hg on a mean of 1.3 ± 1.6 medications. Two eyes responded to cycloplegia, 7 to laser iridozonulohyaloidotomy, and 6 to anterior chamber reformation-IOL pushback; 5 eyes required vitrectomy. Posttreatment, the mean refraction was -0.56 ± 1.07 D; the mean ACD, 3.30 ± 0.50 mm; and the mean IOP, 14.4 ± 4.60 mm Hg on a mean of 1.2 ± 1.4 medications. Cycloplegia was discontinued in 17 eyes.
  
  
  CONCLUSIONS
  Malignant glaucoma can occur after phacoemulsification and presents with myopic surprise, anterior chamber shallowing and, possibly, elevated IOP.
  
  
  BACKGROUND
  No author has a financial or proprietary interest in any material or method mentioned.
authors.affiliation: From the University of Toronto (Varma, Belovay, Tam, Ahmed), Toronto, Trillium Health Partners (Varma, Ahmed), and Credit Valley EyeCare (Varma, Tam, Ahmed), Mississauga, Ontario, Canada. Electronic address: devesh.varma@goeyecare.com.
authors.forename: Devesh K
authors.initials: DK
authors.lastname: Varma
authors.affiliation: From the University of Toronto (Varma, Belovay, Tam, Ahmed), Toronto, Trillium Health Partners (Varma, Ahmed), and Credit Valley EyeCare (Varma, Tam, Ahmed), Mississauga, Ontario, Canada.
authors.forename: Graham W
authors.initials: GW
authors.lastname: Belovay
authors.affiliation: From the University of Toronto (Varma, Belovay, Tam, Ahmed), Toronto, Trillium Health Partners (Varma, Ahmed), and Credit Valley EyeCare (Varma, Tam, Ahmed), Mississauga, Ontario, Canada.
authors.forename: Diamond Y
authors.initials: DY
authors.lastname: Tam
authors.affiliation: From the University of Toronto (Varma, Belovay, Tam, Ahmed), Toronto, Trillium Health Partners (Varma, Ahmed), and Credit Valley EyeCare (Varma, Tam, Ahmed), Mississauga, Ontario, Canada.
authors.forename: Iqbal Ike K
authors.initials: II
authors.lastname: Ahmed
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000867:Anterior Chamber / Q000473:pathology; D003131:Combined Modality Therapy; D005260:Female; D005901:Glaucoma / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D006068:Gonioscopy; D006801:Humans; D007429:Intraocular Pressure; D007498:Iris / Q000601:surgery; D053844:Lasers, Solid-State / Q000627:therapeutic use; D019654:Lens Implantation, Intraocular; D008875:Middle Aged; D009184:Mydriatics / Q000627:therapeutic use; D009216:Myopia / Q000209:etiology; D018918:Phacoemulsification; D011183:Postoperative Complications; D012189:Retrospective Studies; D041623:Tomography, Optical Coherence; D014792:Visual Acuity
chemical_list: D009184:Mydriatics