[Acute attacks in pseudoexfoliative glaucoma]

Clinical picture and the results of treatment of an acute attack in 23 eyes with open-angle pseudoexfoliative glaucoma are presented. A total of 47.9 percent of patients were hospitalized with erroneous diagnoses of neovascular, phacolytic, uveal, phacotopic glaucoma or suspected neoplastic process. Blurred clinical picture of the acute attack could be responsible for the erroneous diagnosis: the painful syndrome was not manifest, the anterior chamber depth and pupil width were normal, the patients presented with insignificant corneal edema and rubeosis, posterior synechia, hyphema, and iridophacodonesis. Gonioscopy showed an open anterior chamber angle with manifest exogenic pigmentation of all the areas and with endogenic pigmentation of Schlemm's canal. Sinuso-trabeculectomy or deep sclerectomy was carried out in 20 eyes, in 8 eyes with cataract extraction. Expulsive hemorrhages occurred in 2 eyes, in 1 case eventuating in enucleation. Primary enucleation was carried out in 3 blind eyes. Surgery resulted in normalization of intraocular pressure in 19 eyes. Vision acuity of 0.1-0.3 diopters was achieved in 6 eyes, 0.02-0.08 in 8 eyes, and remained 0 in 5 eyes. Glaucoma was developing in 3 eyes, far-advanced in 15, and terminal in 1. The authors claim that dystrophic changes of ocular tissues are a characteristic feature associated with acute attacks in pseudoexfoliative glaucoma.(ABSTRACT TRUNCATED AT 250 WORDS)