Cornea Cases

Title:

Management of malignant glaucoma and following complications after penetrating keratoplasty

Case Report Details

First Author: M.Sarnat-Kucharczyk POLAND

Co Author(s):    E. Magnucka   L. Drzyzga   E. Mrukwa-Kominek              

Abstract Details

Purpose:

The aim is to describe a case of 67-years-old female with malignant glaucoma after penetrating keratoplasty and to present problem solving pathway in the management of intraocular fluctuations.

Setting:

Department Ophthalmology, Faculty of Medical Sciences in Katowice, Medical University of Silesia, Katowice, Poland; Head: Professor Ewa Mrukwa-Kominek

Report of case or case series:

67-years-old female diagnosed with congenital absence of hair was admitted due to corneal melting after keratoplasty because of corneal ulceration with hand movement of the left eye. During ophthalmic evaluations at Ophthalmology Department best corrected visual acuity, intraocular pressure, ultrasonography, optical coherence tomography of the cornea were all performed. Penetrating keratoplasty was performed without complications. In the first day she had intraocular rise controlled by topical and systemic antiglaucoma medications. During her follow-up visit after one week she complained about severe headache and eye pain. She was diagnosed with malignant glaucoma and pars plana vitrectomy was performed. After surgery patient had serous choroidal detachment. Visual loss secondary to refractory hypotony was treated with an intracameral injection of high-molecular-weight ocular viscoelastic devices.

Conclusions/Take Home Message:

Malignant glaucoma is a rare ocular complication after penetrating keratoplasty. Management of this complication may induce other problems such as severe hypotony. Early diagnosis and treatment is essential in prevention of visual acuity loss.