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Treatment modalities of malignant glaucoma following trabeculectomy or cataract surgery in narrow-angle glaucoma patients

Poster Details

First Author: B.Satana TURKEY

Co Author(s):    M. Faiz Turan   C. Altan   B. Basarir   I. Pasaoglu   N. Alagoz   A. Demirok

Abstract Details



Purpose:

To evaluate the treatment results of patients who developed malignant glaucoma after trabeculectomy or cataract surgery.

Setting:

Retrospective clinical study

Methods:

Between January 2010-December 2013, 8 narrow angle or angle closure glaucoma patients (9 eyes) developed malignant glaucoma after either trabeculectomy or cataract surgery, included to the study. Best corrected visual acuity (BCVA), intra ocular pressure (IOP) and anterior chamber depth (ACD) via anterior segment optical coherence tomography (OCT), Vizante OCT were determined before and after malignant glaucoma treatment.

Results:

The mean age was 56.55±21.94 years (range 21-82 years). Four of patients (44%) were male. While 3 eyes (33.3%) developed malignant glaucoma after cataract surgery, 7 eyes (66.7%) developed after trabeculectomy. Only 2 (%22.2) eyes were phakic and one of these eyes (11.1%) has treated with medical therapy only. Pars plana core vitrectomy and zonulohyaloidectomy was performed to 7 (77.7%) patients. The other phakic eye (11.1%) had only core vitrectomy initially followed by a clear lens extraction because of uncontrolled IOP and shallow anterior chamber depth. The mean IOP and ACD, before and after treatment were 25.12±7.5mmHg (range14-35 mmHg) and 11.62±2.97 mmHg (range 9-16 mmHg) (p≤0.001); 1.11±0.88 mm (range 0-2.10 mm) and 3.14±0.39 mm (range 2.59-3.53 mm) (paired-sample t-test, p≤0.045) respectively.

Conclusions:

Although malignant glaucoma is a very rare clinical challenge for glaucoma specialists, initial medical treatment (rarely effective), pars plana virectomy and zonulohyaloidectomy and if needed clear lensectomy were effective treatment steps in management of malignant glaucoma. FINANCIAL INTEREST: NONE

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