First Author: O.LE QUOY FRANCE
Co Author(s):
Purpose:
Ten cases of subaccute malignant glaucoma are presented.
Setting:
: hospital and private practice
Methods:
These series include nine hyperopic eyes with mean axial length of 21.04( 16.92 to 22.39 mm) wich underwent uncomplicated phacoemulsification with IOL implantation and one phacic eye. Trabeculectomy was associated in one case and keratoplasty in one case. The anterior chambers were very shallow including two that were completely flat. Mean refraction was - 4.75 D ( -1.75 D, and -8.00 D). Three eyes had elevated IOP medically uncontrolled and one had hypotony. Atropine and Diamox treatment restored emmetropia in 4 cases. Echo B showed a complete posterior vitreous detachment in 3 cases.
Results:
Vitrectomy was performed 0.5 to 36 months after cataract surgery. In all cases, the anterior vitreous was thick . The phacic eye was operated on with a combined procedure with IOL implantation. Posterior vitrectomy was performed followed by a zonulotomy and peripheral iridotomy. Peroperatively, retinal tears occurred in three cases and were treated successfully with pneumoretinopexy. Postoperatively, deep anterior chamber, stable refraction and normal ocular pressure were observed in 10 cases.
Conclusions:
A ciliary block (malignant glaucoma) mechanism may be present in hyperopic eyes , suggested by a sudden myopisation, due to anterior displacement of the lense or IOL. The ultimate treatment is vitrectomy, despite the risk of retinal detachment in eyes without a pre-existing PVD.
Financial Disclosure:
No
