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Related Concept Videos

Angle Closure Glaucoma: Treatment01:28

Angle Closure Glaucoma: Treatment

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Angle-closure glaucoma, or closed-angle glaucoma, is an eye condition where the iris bulges out and blocks the iridocorneal angle, resulting in a buildup of aqueous humor and increased intraocular pressure. Immediate medical attention is necessary due to the sudden onset of symptoms. The treatment for angle-closure glaucoma includes short-term and long-term approaches. Short-term treatment involves using eye drops like pilocarpine to lower intraocular pressure by increasing aqueous humor...
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Glaucoma: Overview01:25

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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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Open Angle Glaucoma: Treatment01:27

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In open-angle glaucoma, the iridocorneal angle remains open, but the trabecular meshwork becomes stiff, slowing down the outflow of aqueous humor. This causes a buildup of aqueous humor in the anterior chamber, leading to a sudden increase in intraocular pressure. The treatment for open-angle glaucoma focuses on reducing the elevated intraocular pressure by either decreasing the secretion of aqueous humor or increasing its outflow.
Drugs such as carbonic anhydrase inhibitors, α2- and...
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Malignant Glaucoma Following Gonioscopy-Assisted Transluminal Trabeculotomy.

Murat Gunay1, Adem Turk1, Omer Koksal Kurutas1

  • 1Department of Ophthalmology, Faculty of Medicine, Karadeniz Technical University.

Journal of Glaucoma
|May 13, 2025
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Summary

Malignant glaucoma (MGL) occurred in 4 patients after gonioscopy-assisted transluminal trabeculotomy (GATT). Early detection and treatment of MGL are crucial for managing primary angle-closure glaucoma (PACG) and preventing further vision loss.

Keywords:
glaucomagonioscopy-assisted transluminal trabeculotomymalignantsurgery

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Area of Science:

  • Ophthalmology
  • Glaucoma Research
  • Surgical Outcomes

Background:

  • Primary angle-closure glaucoma (PACG) poses a significant risk for vision impairment.
  • Gonioscopy-assisted transluminal trabeculotomy (GATT) is a surgical option for PACG.
  • Malignant glaucoma (MGL) is a rare but serious complication that can occur post-ophthalmic surgery.

Purpose of the Study:

  • To report the occurrence of malignant glaucoma (MGL) following gonioscopy-assisted transluminal trabeculotomy (GATT).
  • To evaluate the clinical characteristics and treatment outcomes of MGL post-GATT.
  • To highlight the importance of recognizing MGL in patients with specific preoperative risk factors.

Main Methods:

  • Observational case-series study of 4 consecutive patients.
  • Inclusion criteria: PACG patients who underwent GATT and subsequently developed MGL.
  • Data collected: Preoperative characteristics (refraction, anterior segment imaging), intraocular pressure (IOP) before and after GATT, MGL diagnosis, and treatment outcomes.

Main Results:

  • Four cases of MGL (1.3% incidence) were observed after GATT in patients with PACG.
  • All patients had preoperative plateau iris configuration, hypermetropia, and peripheral anterior synechiae.
  • MGL was diagnosed on postoperative day 1, with IOP ranging from 19-29 mmHg. Treatments included pars plana vitrectomy and irido-zonulo-hyaloido-vitrectomy (IZHV).

Conclusions:

  • Malignant glaucoma (MGL) can occur after gonioscopy-assisted transluminal trabeculotomy (GATT), particularly in patients with primary angle-closure glaucoma (PACG) and plateau iris.
  • Prompt diagnosis and appropriate surgical intervention are essential for managing post-GATT MGL.
  • Further research is needed to understand the precise mechanisms and optimize prevention strategies for MGL after GATT.