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[The congener eye in patients with unilateral classical malignant glaucoma]
Purpose:
To prospectively study in a follow-up period, ranging from 5 to 20 years, "the fate" of the fellow eye in patients with unilateral classical malignant glaucoma.
Methods:
The fellow eye of 10 patients had been thoroughly examined immediately after the beginning of an adequate therapy of the unilateral classical malignant glaucoma.
Results:
In 6 cases the fellow eye was apparently normal and 4 cases exhibited an intermittent primary angle-closure glaucoma. Surgery of the fellow eye was accepted immediately by two patients; in one a peripheral iridectomy was carried out and in the other one a trabeculectomy. The other 8 patients initially turned down surgery but accepted in thereafter in a period of time ranging between 1 and 8 years. A peripheral iridectomy was performed in two cases, a trabeculectomy in other two and a combined procedure (trabeculectomy with pars plana aspiration of the aqueous trapped within the vitreous in 3 cases and the same procedure plus lens extraction on one patient) in the remaining 4 cases, since they developed into a primary chronic angle-closure glaucoma.
Conclusions:
Prophylactic surgery should be best done when the fellow eye is apparently normal having an entirely open angle and both the ocular tension and the visual function normal. The treatment of the advanced primary chronic angle-closure glaucoma of the fellow eye consists in trabeculectomy with pars plana aspiration associated with cataract extraction if the lens is opaque.