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Glaucoma is an eye condition characterized by increased intraocular pressure that damages the retina and optic nerve, leading to irreversible blindness if left untreated. The human eye has various components, including the cornea, iris, pupil, lens, and optic nerve. Aqueous humor is secreted by the epithelium of the ciliary body in the posterior chamber and flows through the trabecular meshwork and canal of Schlemm, maintaining normal intraocular pressure. The trabecular meshwork and the canal...
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Malignant glaucoma after cataract surgery.

Devesh K Varma1, Graham W Belovay1, Diamond Y Tam1

  • 1From the University of Toronto (Varma, Belovay, Tam, Ahmed), Toronto, Trillium Health Partners (Varma, Ahmed), and Credit Valley EyeCare (Varma, Tam, Ahmed), Mississauga, Ontario, Canada.

Journal of Cataract and Refractive Surgery
|September 25, 2014
PubMed
Summary
This summary is machine-generated.

Malignant glaucoma can occur after cataract surgery, causing myopic surprise and shallowing of the anterior chamber. Treatment involves medical therapy, laser procedures, and potentially surgery to manage intraocular pressure.

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Area of Science:

  • Ophthalmology
  • Glaucoma Research
  • Surgical Complications

Background:

  • Malignant glaucoma is a rare but serious complication that can occur after cataract surgery.
  • Understanding its presentation and treatment is crucial for effective patient management.

Purpose of the Study:

  • To describe a series of eyes that developed malignant glaucoma following cataract surgery.
  • To analyze the treatment outcomes for this condition.

Main Methods:

  • A retrospective case series was conducted at a private academic practice.
  • Eyes with malignant glaucoma post-cataract surgery were treated sequentially with medical therapy, laser iridozonulohyaloidotomy, anterior chamber reformation with intraocular lens (IOL) pushback, and vitrectomy if necessary.
  • Refraction, intraocular pressure (IOP), gonioscopy, and anterior chamber depth (ACD) were assessed before and after treatment.

Main Results:

  • The study included 20 eyes from 18 female patients (age 44-86).
  • Malignant glaucoma was diagnosed a mean of 5.8 weeks postoperatively, presenting with myopic shift, shallow ACD (2.49 mm), and elevated IOP (28.3 mm Hg).
  • Treatment success varied: 2 eyes responded to cycloplegia, 7 to laser, 6 to anterior chamber reformation/IOL pushback, and 5 required vitrectomy. Post-treatment, mean ACD improved to 3.30 mm and mean IOP to 14.4 mm Hg.

Conclusions:

  • Malignant glaucoma is a potential complication of phacoemulsification (cataract surgery).
  • Key clinical signs include myopic surprise, shallow anterior chamber, and elevated IOP.
  • A stepwise treatment approach can effectively manage this condition.