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Updated: Feb 10, 2026
10:35
Microvascular Decompression: Salient Surgical Principles and Technical Nuances
Published on: July 5, 2011
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Acute Glaucoma Attack Following Microvascular Decompression Surgery for Trigeminal Neuralgia
Kenichi Amagasaki1, Masami Nagayama2, Saiko Watanabe1
1Department of Neurosurgery, Mitsui Memorial Hospital.
Neurologia Medico-Chirurgica
|May 18, 2018
Summary
Microvascular decompression for trigeminal neuralgia can lead to acute angle-closure glaucoma, especially in elderly patients. Lateral positioning during and after surgery may increase intraocular pressure and trigger this serious complication.
Area of Science:
- Neurosurgery
- Ophthalmology
- Geriatric Medicine
Background:
- Microvascular decompression (MVD) is a primary surgical treatment for trigeminal neuralgia (TN).
- While effective, MVD carries risks of morbidity and mortality.
- Elderly patients may have unique postoperative considerations.
Observation:
- An elderly female patient developed acute angle-closure glaucoma post-MVD for TN.
- The patient was positioned in left lateral decubitus during and after surgery.
- Postoperative left ocular pain, visual disturbance, and elevated intraocular pressure (IOP) were noted.
Findings:
- Diagnosis of acute angle-closure glaucoma was confirmed with dilated pupil, light perception, and high IOP (44 mmHg).
- Treatment included mannitol and emergent laser iridotomy.
- Visual acuity and IOP normalized post-intervention.
Implications:
- Lateral positioning during and after MVD may increase IOP in the dependent eye, precipitating acute angle-closure glaucoma.
- Age is a critical factor, increasing susceptibility in elderly patients.
- Clinicians should consider this potential complication in postoperative patient management.
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