Two cases of malignant glaucoma unresolved by pars plana vitrectomy

Area of Science:

• Ophthalmology
• Glaucoma Research

Background:

• Malignant glaucoma (MG) presents with a shallow anterior chamber and elevated intraocular pressure (IOP).
• Pars plana vitrectomy with anterior hyaloidectomy is the standard treatment for MG.
• Refractory cases of MG pose a significant clinical challenge.

Purpose of the Study:

• To report two cases of malignant glaucoma refractory to standard surgical management.
• To evaluate the efficacy of peripheral iridectomy with or without local zonulectomy in refractory MG.

Main Methods:

• Case report of two patients with pseudoexfoliation glaucoma who developed refractory malignant glaucoma.
• Surgical interventions included pars plana vitrectomy, peripheral iridectomy, local zonulectomy, goniosynechialysis, and trabectome surgery.

Main Results:

• Both patients achieved successful IOP control after undergoing peripheral iridectomy combined with other procedures.
• One patient required peripheral iridectomy and local zonulectomy after recurrence post-vitrectomy.
• The second patient underwent peripheral iridectomy, goniosynechialysis, and trabectome surgery for refractory MG.

Conclusions:

• Peripheral iridectomy with or without local zonulectomy is a viable surgical option for malignant glaucoma refractory to vitrectomy.
• These procedures represent a minimally invasive approach for managing complex glaucoma cases.
• Successful IOP management was achieved in challenging malignant glaucoma scenarios.