Videoendoscope-Guided Fluorescein-Assisted Vitrectomy for Phakic Malignant Glaucoma

Abstract

alignant glaucoma is a rare secondary glaucoma classically occurring after intraocular surgery in eyes with primary angle closure. Pars plana vitrectomy is reserved for the treatment of malignant glaucoma when medical and laser treatment fail. The primary aim of surgery is the removal of the anterior vitreous to reduce resistance to aqueous flow into the anterior chamber. In phakic eyes, conventional pars plana vitrectomy without lens extraction is frequently unsuccessful because of difficulty visualizing the normally transparent anterior vitreous, combined with the technical challenge of removing the anterior vitreous without damaging the crystalline lens. We describe a technique of intraocular, videoendoscope-guided, fluorescein-assisted pars plana vitrectomy that enables direct visualization and thorough removal of the anterior vitreous without the need for lens extraction in prepresbyopic patients without cataract.

Clinical efficacy of modified partial pars plana vitrectomy combined with phacoemulsification for malignant glaucoma

“…The mean duration of malignant glaucoma was 8.6 ± 2.8 days (range: [4][5][6][7][8][9][10][11][12][13][14]. The average axial length of the eyes was 21.3 ± 0.8 mm.…”

Clinical efficacy of modified partial pars plana vitrectomy combined with phacoemulsification for malignant glaucoma

“…The mean duration of malignant glaucoma was 8.6 ± 2.8 days (range: [4][5][6][7][8][9][10][11][12][13][14]. The average axial length of the eyes was 21.3 ± 0.8 mm.…”

Spontaneous onset pseudophakic malignant glaucoma secondary to zonular weakness and cilio-lenticular block

“…Techniques to assist disruption include intraocular video-endoscope-guided and fluorescein-assisted PPV. [ 19 ] In the main-stay, adequate management of MG in phakic individuals invariably requires the combination of phacoemulsification with vitrectomy, posterior capsulotomy, and subsequent IOL implant. Staged approaches, with initial vitrectomy to soften the eye, deepening the AC are advocated, overcoming difficulties associated with performing phacoemulsification in eyes with shallow AC's and raised IOP.…”

Long-term follow-up of zonulo-hyaloido-vitrectomy for pseudophakic malignant glaucoma

“…It is evident that malignant glaucoma may occur after a complete vitrectomy unless the vitreous base is also removed. [ 5 23 24 ]…”

Clinical efficacy of modified partial pars plana vitrectomy combined with phacoemulsification for malignant glaucoma

“…The mean duration of malignant glaucoma was 8.6 ± 2.8 days (range: [4][5][6][7][8][9][10][11][12][13][14]. The average axial length of the eyes was 21.3 ± 0.8 mm.…”

Spontaneous onset pseudophakic malignant glaucoma secondary to zonular weakness and cilio-lenticular block

“…Techniques to assist disruption include intraocular video-endoscope-guided and fluorescein-assisted PPV. [ 19 ] In the main-stay, adequate management of MG in phakic individuals invariably requires the combination of phacoemulsification with vitrectomy, posterior capsulotomy, and subsequent IOL implant. Staged approaches, with initial vitrectomy to soften the eye, deepening the AC are advocated, overcoming difficulties associated with performing phacoemulsification in eyes with shallow AC's and raised IOP.…”

Long-term follow-up of zonulo-hyaloido-vitrectomy for pseudophakic malignant glaucoma

“…It is evident that malignant glaucoma may occur after a complete vitrectomy unless the vitreous base is also removed. [ 5 23 24 ]…”

Clinical efficacy of modified partial pars plana vitrectomy combined with phacoemulsification for malignant glaucoma

“…The mean duration of malignant glaucoma was 8.6 ± 2.8 days (range: [4][5][6][7][8][9][10][11][12][13][14]. The average axial length of the eyes was 21.3 ± 0.8 mm.…”

Spontaneous onset pseudophakic malignant glaucoma secondary to zonular weakness and cilio-lenticular block

“…Techniques to assist disruption include intraocular video-endoscope-guided and fluorescein-assisted PPV. [ 19 ] In the main-stay, adequate management of MG in phakic individuals invariably requires the combination of phacoemulsification with vitrectomy, posterior capsulotomy, and subsequent IOL implant. Staged approaches, with initial vitrectomy to soften the eye, deepening the AC are advocated, overcoming difficulties associated with performing phacoemulsification in eyes with shallow AC's and raised IOP.…”

Long-term follow-up of zonulo-hyaloido-vitrectomy for pseudophakic malignant glaucoma

“…It is evident that malignant glaucoma may occur after a complete vitrectomy unless the vitreous base is also removed. [ 5 23 24 ]…”