25-Gauge pars plana vitrectomy for ciliary block (malignant) glaucoma

Area of Science:

• Ophthalmology
• Surgical Innovation

Background:

• Malignant glaucoma, a rare and severe form of angle-closure glaucoma, presents a significant challenge in intraocular pressure (IOP) management.
• Traditional treatments may not always be effective, necessitating exploration of alternative surgical interventions.

Purpose of the Study:

• To evaluate the efficacy and safety of 25-gauge pars plana vitrectomy (PPV) for treating malignant glaucoma.
• To assess the outcomes of combining 25-gauge PPV with phacoemulsification surgery in phakic patients.

Main Methods:

• Retrospective review of medical records for 11 eyes across nine patients diagnosed with malignant glaucoma.
• Evaluation of IOP control, best-corrected visual acuity (BCVA), and intra/postoperative complications following 25-gauge PPV.

Main Results:

• Prompt resolution of malignant glaucoma with no observed recurrence during a mean follow-up of 12.7 months.
• Significant reduction in mean IOP from 35.9 mmHg preoperatively to 16.0 mmHg postoperatively (P=0.013).
• Improvement in mean BCVA from +0.69 to +0.29 (P=0.027), with all eyes achieving IOP control, though two required long-term medication.

Conclusions:

• 25-gauge PPV is a safe and effective surgical procedure for managing malignant glaucoma.
• Combining vitrectomy with phacoemulsification and employing a staged surgical approach may enhance treatment success rates.