title: Malignant glaucoma-like syndrome after EX-PRESS filtration surgery.
abstract: OBJECTIVE
  To report a case of postsurgical shallow anterior chamber and elevated intraocular pressure (IOP) simulating malignant glaucoma.
  
  
  METHODS
  A 20-year-old woman underwent EX-PRESS® device implant for treatment of primary open-angle glaucoma.
  
  
  RESULTS
  Postoperative examination showed a shallow anterior chamber, the EX-PRESS® device embedded in the iris, an IOP of 28 mm Hg, and an annular detachment of the choroid ciliary body, suggesting hyperfiltration followed by EX-PRESS® blockage. The anterior chamber was restored using an ophthalmic viscoelastic and an additional suture was applied ensuring the scleral flap. The IOP progressively decreased in the following days and the anterior chamber remained deep and stable. New ocular ultrasonography showed complete resolution of the ciliary body detachment 15 days after surgery.
  
  
  CONCLUSIONS
  After glaucoma surgery, not every patient with shallow anterior chamber and normal or high IOP necessarily has a ciliary block glaucoma. In our case, hyperfiltration led to choroidal expansion, shallow anterior chamber, obstruction of the EX-PRESS®, and secondary blockage of outflow. The differential diagnosis is important in order to avoid further invasive procedures (i.e., lensectomy or vitrectomy).
authors.forename: Giamberto
authors.initials: G
authors.lastname: Casini
authors.forename: Pasquale
authors.initials: P
authors.lastname: Loiudice
authors.forename: Paolo
authors.initials: P
authors.lastname: Martinelli
authors.forename: Francesco
authors.initials: F
authors.lastname: Nasini
authors.forename: Marco
authors.initials: M
authors.lastname: Nardi
mesh_terms: D000867:Anterior Chamber / Q000473:pathology*; D005260:Female; D018463:Filtering Surgery; D020327:Glaucoma Drainage Implants; D005902:Glaucoma, Open-Angle / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D007429:Intraocular Pressure / Q000502:physiology; D009798:Ocular Hypertension / Q000209:etiology*; D011183:Postoperative Complications; D055815:Young Adult