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Resistant malignant glaucoma: pars plana vitrectomy outcomes and complications

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Session Details

Session Title: Presented Poster Session: Glaucoma

Venue: Poster Village: Pod 2

First Author: : L.Krepste LITHUANIA

Co Author(s): :    R. Kasperaviciene   A. Miliauskas   R. Zemaitiene        

Abstract Details

Purpose:

To assess outcomes of malignant glaucoma (MG) cases treated with pars plana vitrectomy (PPV) by evaluating the change in intraocular pressure (IOP), the further IOP lowering measures and occurring of postoperative complications.

Setting:

Lithuanian University of Health Sciences

Methods:

Retrospective analysis of all MG cases (43 eyes of 43 patients) resistant to topical and systemic intraocular pressure (IOP) lowering therapy and/or iridotomy, which were treated performing PPV in tertiary care center, Eye Clinic of Lithuanian University of Health Sciences, between January 2005 and December 2015. All data analyses were conducted with Statistical Package for Social Sciences, IBM 20.0. Statistical significance was set at p<0.05. Quantitative data are presented in means with standard deviation.

Results:

Twenty-one (46.5%) cases evolved after cataract surgery, 11 (25.6%) – after trabeculectomy in phacic eyes, 4 (9.3%) – after trabeculectomy in pseudophacic eyes. Twenty-eight (65.1%) patients were previously diagnosed with angle-closure and 7 (16.3%) –with open-angle glaucoma. Normotension was achieved with significant IOP reduction from 38.4±6.5 to 13.1±4mmHg in 40 cases (93%) – 17 cases (39.5%) with PPV, 21 (48.8%) with PPV and topical therapy and 2 cases (4.7%) required additional trabeculectomy. The number of IOP-lowering medications significantly decreased from 2±1.2 before diagnosing MG to 1.5±1.5 after PPV. Six PPV complications were observed (choroidal detachment, 2retinal detachments, 3pupilary blocks).

Conclusions:

PPV is highly effective in treating resistant malignant glaucoma cases. PPV has a potential to reduce the number of required topical IOP lowering medications in glaucoma patients. The need of futher surgical intervention after PPV is low, but post-PPV complications should be expected.

Financial Disclosure:

NONE

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