Single-port transconjunctival vitrectomy for malignant glaucoma

Area of Science:

• Ophthalmology
• Surgical Innovation

Background:

• Malignant glaucoma management traditionally involves complex procedures like anterior vitrectomy with zonulectomy and iridectomy or 3-port core pars plana vitrectomy (PPV).
• Existing methods require specialized surgical expertise and can be associated with significant complications.

Purpose of the Study:

• To present a modified surgical technique for malignant glaucoma management.
• To evaluate the efficacy and safety of a single-port vitrector approach for anterior vitrectomy and posterior capsulotomy.

Main Methods:

• A modified technique involving synechiolysis and anterior chamber irrigation through a limbal incision.
• Introduction of a single-port 23- or 25-gauge vitrector via pars plana vitrectomy (PPV) for anterior vitrectomy and central posterior capsulotomy.
• The procedure was adapted for both pseudophakic and phakic eyes, continuing vitrectomy until anterior chamber deepening.

Main Results:

• Successful optimization of anterior chamber depth in all 9 treated eyes.
• Intraocular pressure normalization achieved in 8 out of 9 eyes.
• No recurrence of malignant glaucoma observed during a mean follow-up of 8.6 months.

Conclusions:

• The proposed modified surgical technique offers a potentially simpler and effective approach to malignant glaucoma management.
• This method successfully deepens the anterior chamber and normalizes intraocular pressure, bypassing the need for posterior iridectomy/zonulectomy.
• The procedure demonstrates favorable outcomes and a low recurrence rate, suggesting its clinical utility.