Treatment Outcomes in Malignant Glaucoma

Dave, Paaraj; Senthil, Sirisha; Rao, Harsha L.; Garudadri, Chandra S.

doi:10.1016/j.ophtha.2012.10.024

Cited by 68 publications

(66 citation statements)

References 32 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…30 These observations reveal the importance of achieving a patent communication between the vitreous cavity and the anterior chamber. The various surgical modalities described since the year 2000 emphasize the importance of producing this communication by performing an adequate peripheral iridectomy, capsulotomy and hyaloido zonulotomy either by the anterior or by the pars (Table 3) [31][32][33][34][35] In addition, conventional vitrectomy, when performed alone, did result in a relapse rate as high as 75%, supporting the concept. 30 Hosada et al 36 describe two cases of malignant glaucoma which occurred following complete pars plana vitrectomy and ultimately resolved following peripheral iridectomy with or without local zonulectomy.…”

Section: Discussionmentioning

confidence: 85%

Surgical management of malignant glaucoma: a retrospective analysis of fifty eight eyes

Balekudaru

Choudhari

Rewri

et al. 2017

Eye

View full text Add to dashboard Cite

PurposeTo assess outcomes of surgical management of malignant glaucoma in terms of re-formation of anterior chamberMethodsThis was a retrospective analysis of consecutive patients who underwent surgical treatment for malignant glaucoma between January 1995 and December 2013 at a tertiary care ophthalmic institute, with a minimum follow up of 2 months.ResultsFifty eight eyes of 58 patients were included. Fifty two (89.7%) patients had primary angle closure glaucoma. The majority had undergone glaucoma filtration surgery earlier (n=53, 91.4%). Lensectomy and anterior vitrectomy was performed in 15 (25.9%) eyes (Group 1). Vitrectomy and anterior chamber re-formation was performed in 27 (46.6%) eyes (Group 2). Vitrectomy-phacoemulsification-vitrectomy was performed in 16 (27.6%) eyes (Group 3). Communication between the two segments of eye through anterior hyaloid, lens capsule complex and/or iris was achieved in all groups. The median follow-up (Inter-quartile range) was 30 (71.5) months. Anterior chamber re-formation was achieved in 56 (96.5%) eyes at final visit. The improvement in mean±SD LogMAR visual acuity (1.1±1 to 0.7±0.8) and reduction in number ±SD of anti-glaucoma medications (2.1±1.1 to 1±1.6) between onset and final visit were significant (P=0.02 and <0.01, respectively). The intraocular pressure (mm Hg) at onset and at final visit was 30.7±17.4 and 14±6.2, 32.8±12.6 and 15.3±7.4, and 27.2±14 and 10.9±3 in groups 1-3, respectively (all P<0.01).ConclusionOur anatomical success rate was high. The key element in achieving this outcome was the establishment of a patent communication between the vitreous cavity and the anterior chamber.

show abstract

Section: Discussionmentioning

confidence: 85%

Surgical management of malignant glaucoma: a retrospective analysis of fifty eight eyes

Balekudaru

Choudhari

Rewri

et al. 2017

Eye

View full text Add to dashboard Cite

show abstract

“…The definition of resolution along with the outcomes of MG management and our treatment algorithm are detailed in our previous publication 11. Recurrence was defined as the re-shallowing of the central AC after the initial deepening with IOP≥21 mm Hg.…”

Section: Discussionmentioning

confidence: 99%

Recurrence of aqueous misdirection following pars plana vitrectomy in pseudophakic eyes

et al. 2015

View full text Add to dashboard Cite

SUMMARYWe present a retrospective interventional case series of four patients with pseudophakic eye who developed recurrent aqueous misdirection following pars plana vitrectomy (PPV) for malignant glaucoma (MG). The patients were treated with neodymium: YAG (Yttrium Aluminum Garnet) laser hyaloidotomy/membranotomy through the patent peripheral iridectomy. The main outcome measure was resolution of MG. The intervention resulted in resolution of MG in all four cases. The cause for recurrence was an inflammatory membrane covering the hyaloidotomy opening in three eyes and the haptic of intraocular lens blocking the hyaloidotomy opening in one eye. Recurrence of aqueous misdirection even after vitrectomy may be related to obstruction of aqueous flow through the communication created, either by intraocular lens or fibrin. Treatment of this condition involves restoring aqueous flow to the anterior chamber from the anterior vitreous by treating the cause, and most often the YAG laser hyaloidotomy/ membranotomy is successful in relieving the condition. BACKGROUND

show abstract

“…However, previous studies showed that the success rate of both medications and laser therapy is low [5][6][7]. While transscleral cyclophotocoagulation helps to achieve optimum eye resolution in most cases, but it may also damage tissues such as the ciliary processes, sclera, and conjunctiva [8,9]. As a result, anterior vitrectomy remains as an important choice for FMS.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of Two Different Anterior Vitrectomies for Fluid Misdirection Syndrome Secondary to Cataract Surgery Combined with Goniosynechialysis

Qian

Chan

Wei

et al. 2020

Journal of Ophthalmology

View full text Add to dashboard Cite

Purpose. To evaluate two different approaches of anterior vitrectomy combined with hyaloidotomy, zonulectomy, and iridectomy (VHZI) for fluid misdirection syndrome (FMS) secondary to phacoemulsification with intraocular lens implantation combined with goniosynechialysis (phaco-IOL-GSL). Methods. Nine patients with FMS who developed after a phaco-IOL-GSL procedure, were retrospectively studied from May 2015 to February 2018. They were treated with VHZI, in which 5 cases underwent local anterior vitrectomy via anterior chamber approach, and the others underwent comprehensive vitrectomy via pars plana approach. Main outcome measures were pre- and postoperative intraocular pressure (IOP), number of antiglaucoma medications, and relapse rate. Results. Incidence of FMS secondary to phaco-IOL-GSL was 1.4% (9 in 652 eyes), which was promptly resolved in all affected cases. VHZI via anterior chamber approach resulted in a significant decrease in the mean IOP from 40.2 ± 9.7 mm Hg at presentation to 15.2 ± 4.8 mm Hg postoperatively (P=0.01). The median number of antiglaucoma medications reduced from 3 to 2 (P=0.066). Meanwhile, VHZI via pars plana approach also resulted in the reduction of the mean IOP values from 26.0 ± 5.7 mm Hg at presentation to 15.2 ± 3.3 mm Hg postoperatively (P=0.092). The median number of antiglaucoma medications also reduced from 3.5 to 1.5 (P=0.059). Relapse rate of the treatment through pars plana approach (0%, 0/4) was much lower than that through anterior chamber approach (40%, 2/5), although the difference was not statistically significant (P=0.444). Conclusions. FMS is a rare but severe complication secondary to phaco-IOL-GSL. Compared to VHZI with local anterior vitrectomy via anterior chamber approach, VHZI with comprehensive anterior vitrectomy via pars plana approach might be a more effective procedure to treat FMS. The study has been registered in Contact ClinicalTrials.gov PRS Identifier: NCT04172857.

show abstract

Treatment Outcomes in Malignant Glaucoma

Cited by 68 publications

References 32 publications

Surgical management of malignant glaucoma: a retrospective analysis of fifty eight eyes

Surgical management of malignant glaucoma: a retrospective analysis of fifty eight eyes

Recurrence of aqueous misdirection following pars plana vitrectomy in pseudophakic eyes

Evaluation of Two Different Anterior Vitrectomies for Fluid Misdirection Syndrome Secondary to Cataract Surgery Combined with Goniosynechialysis

Contact Info

Product

Resources

About