Bilateral malignant glaucoma with bullous keratopathy: A case report

Area of Science:

• Ophthalmology
• Glaucoma Research
• Surgical Complications

Background:

• Malignant glaucoma, a severe complication of ocular surgery, involves aqueous misdirection leading to shallow anterior chambers and elevated intraocular pressure.
• Risk factors include short axial length and a history of angle closure glaucoma; incidence ranges from 0.6% to 4.0%.
• This condition can arise after filtering surgeries, laser iridotomy, and cataract surgery.

Observation:

• A case of bilateral malignant glaucoma is presented, with distinct etiologies for each eye.
• The left eye developed bullous keratopathy and required multiple surgical interventions.
• Corneal endothelial decompensation was noted in the left eye following repeated surgeries.

Findings:

• Different management strategies and surgical methods were employed for each eye due to varied causes of malignant glaucoma.
• Successful maintenance of normal anterior chamber depth was achieved in both eyes.
• A retroendothelial fibrous membrane formed in the left eye, partially restoring corneal endothelial function.

Implications:

• This case highlights the complexity of managing bilateral malignant glaucoma with co-existing conditions like bullous keratopathy.
• Tailored surgical approaches are crucial for addressing varied etiologies of malignant glaucoma.
• The formation of a retroendothelial fibrous membrane offers a potential compensatory mechanism for corneal endothelial dysfunction.