Management of Late Onset Sequential Pseudophakic Malignant Glaucoma: A Case Report and Review of Literature

Downloads

Published

2023-11-22

DOI:

https://doi.org/10.56692/upjo.2023110308

Keywords:

Malignant glaucoma, Pseudophakia, Aqueous misdirection, Secondary glaucoma, Nd: YAG laser capsulo-hyaloidotomy, Pars plana vitrectomy, Iridozonulohyaloidectomy

Dimensions Badge

Issue

Vol. 11 No. 03 (2023): UP JOURNAL OF OPHTHALMOLOGY

Section

CASE REPORT

License

Creative Commons License

This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.

© UPJO, 2023 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit https://creativecommons.org/licenses/by-nc-sa/4.0/.

Authors

  • Swati Singh Glaucoma and Cataract Services, Centre for Sight, New Delhi, India
  • Harsh Kumar Glaucoma and Cataract Services, Centre for Sight, New Delhi, India
  • Harish H S Vitreo-retina Services, Centre for Sight, New Delhi, India
  • Surbi Taneja Glaucoma and Cataract, Ahuja Eye Centre, Gurgaon, Haryana, India.

Abstract

Introduction: Malignant glaucoma or aqueous misdirection syndrome (AMS) can present in the immediate post-operative period or even many years after cataract surgery. We report the clinical course and management of a patient who developed the disease in both eyes at different time intervals after uneventful cataract surgery.
Patient and Clinical Findings: A 76-year-old man developed diffusely shallow anterior chamber (AC) and high intraocular pressure (IOP) in his right eye after 2 years of pseudophakia, which did not resolve with laser peripheral iridotomy. A similar episode happened in left eye after 3 years of cataract surgery in the presence of a patent laser iridotomy.
Diagnosis, Interventions, and Outcome: Shallow anterior chamber in the presence of a patent PI and normal posterior segment confirmed the diagnosis. The right eye was successfully managed with Nd:YAG laser capsulo-hyaloidotomy and pharmacotherapy, whereas in left eye, pars plana vitrectomy (PPV) with irido-zonulo-anterior hyaloidectomy (IZH) was done. Recurrence was noted after PPV also, owing to blockage of surgical iridectomy, which was treated with Nd:YAG laser.
Conclusion: Pseudophakic malignant glaucoma can present many years after cataract surgery. Pars plana vitrectomy with IZH is an effective mode of treatment for refractory cases. Laser capsulo-hyaloidotomy may be more useful in the acute phase of the disease.

How to Cite

1.
Singh S, Kumar H, S HH, Taneja S. Management of Late Onset Sequential Pseudophakic Malignant Glaucoma: A Case Report and Review of Literature. UPJO [Internet]. 2023 Nov. 22 [cited 2024 May 18];11(03):95-8. Available from: https://upjo.org/index.php/upjo/article/view/525

Downloads

Download data is not yet available.