Antiglaucomatous ciliary body excision

Between 1974 and 1984, we performed 106 ciliary body excisions in a total of 90 eyes. Of the 85 eyes for which at least six months of follow-up data were available, 72 had secondary partial angle-closure glaucoma with aphakia, ten had secondary partial angle-closure glaucoma without aphakia, and three had secondary open-angle glaucoma. Forty-eight eyes had undergone three or more (in some cases as many as nine) previous antiglaucomatous procedures before ciliary body excision and 27 had undergone one or two previous procedures. Preoperative intraocular pressures ranged from 35 to 60 mm Hg. After six months, intraocular pressure was 19 mm Hg or less in 60 eyes with no other treatment, although ten eyes required a second excision. Another five eyes had intraocular pressures of 19 mm Hg or less with medical therapy (one reoperation) and seven had intraocular pressures of 22 mm Hg or less without medical therapy (one reoperation). Ciliary body excision failed in 13 eyes. Four of these had persistent hypotony (intraocular pressures of less than 4 mm Hg) and nine had intraocular pressures above 40 mm Hg. Reasons for failure included rubeosis iridis (seven eyes), an overlarge excision (three eyes), and expulsive hemorrhage, siderosis bulbi, and Lowe's syndrome (one eye each). Postoperative visual acuity was unchanged in 45 eyes, somewhat improved in 15, and worse in 21.