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Malignant glaucoma occurring 16 years after successful filtering surgery.

P P Ellis

    Annals of Ophthalmology
    |February 1, 1984
    PubMed
    Summary

    Malignant glaucoma can occur years after filtering surgery, even with a functional bleb. Early diagnosis is crucial, as some treatments can worsen this rare condition.

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    Area of Science:

    • Ophthalmology
    • Glaucoma Research
    • Surgical Complications

    Background:

    • Filtering surgery is a common treatment for glaucoma to reduce intraocular pressure (IOP).
    • Successful filtering surgery typically maintains a functional filtering bleb long-term.
    • Malignant glaucoma is a rare, severe form of angle-closure glaucoma.

    Observation:

    • A patient developed malignant glaucoma 16 years post-successful filtering surgery.
    • Initial presentation included a moderate IOP rise despite a patent filtering bleb.
    • Pilocarpine administration exacerbated the condition, mimicking other glaucoma types.

    Findings:

    • Delayed recognition of malignant glaucoma occurred due to atypical presentation.
    • The characteristic deepening of the anterior chamber and IOP drop with cycloplegics confirmed the diagnosis.
    • This case highlights a late-onset complication of glaucoma surgery.

    Implications:

    • Clinicians must consider malignant glaucoma in patients with prior glaucoma surgery, irrespective of bleb function.
    • Careful medication selection is vital, as miotics can precipitate or worsen malignant glaucoma.
    • This case underscores the importance of recognizing atypical presentations of glaucoma, especially in long-term post-surgical patients.

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