title: Aqueous misdirection following pars plana vitrectomy and silicone oil injection.
abstract: OBJECTIVE
  To report a retrospective series of seven phakic eyes of seven patients suffering from a malignant glaucoma-like syndrome following pars plana vitrectomy and silicone oil (SO) injection.
  
  
  METHODS
  Seven eyes with retinal detachment treated with pars plana vitrectomy with or without scleral buckling with SO tamponade. This was followed by cataract extraction to manage the elevated intraocular pressure (IOP).
  
  
  RESULTS
  This was a retrospective review of seven cases that received pars plana vitrectomy and SO with or without scleral buckling for different causes of retinal detachment (three were rhegmatogenous and four were tractional). After a period ranging from 1 week to 1 month, they presented with malignant glaucoma-like manifestations; high IOP, shallow axial anterior chamber, and remarkable decrease of visual acuity. Atropine eye drops and anti-glaucoma medical treatment (topical and systemic) had been tried but failed to improve the condition. Dramatic decrease of IOP and deepening of the axial anterior chamber was observed in all cases in the first postoperative day after phacoemulsification and posterior chamber foldable intraocular lens implantation with posterior capsulotomy.
  
  
  CONCLUSIONS
  Aqueous misdirection syndrome may be observed following pars plana vitrectomy and SO tamponade. This must be differentiated from other causes of post vitrectomy glaucoma. Cataract extraction with posterior capsulotomy controls the condition.
authors.affiliation: Tanta University, Tanta, Egypt ; Magrabi Eye Hospital, Cairo, Egypt.
authors.forename: Hammouda H
authors.initials: HH
authors.lastname: Ghoraba
authors.affiliation: Al-Azhar University, Cairo, Egypt.
authors.forename: Ali Ahmed
authors.initials: AA
authors.lastname: Ghali
authors.affiliation: Magrabi Eye Hospital, Cairo, Egypt ; Al-Azhar University, Cairo, Egypt.
authors.forename: Hosam Othman
authors.initials: HO
authors.lastname: Mansour
keywords: malignant glaucoma; pars plana vitrectomy; silicone oil