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Vitrectomy for ciliary block (malignant) glaucoma

G A Byrnes1, M M Leen, T P Wong

  • 1Department of Ophthalmology, National Naval Medical Center, Bethesda, MD 20889-5000, USA.

Ophthalmology
|September 1, 1995
PubMed
Summary
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Pars plana vitrectomy effectively treats refractory ciliary block glaucoma when other methods fail. This surgical approach aims to restore normal aqueous flow, though complications can occur, especially in phakic eyes.

Area of Science:

  • Ophthalmology
  • Glaucoma Research
  • Surgical Complications

Background:

  • Ciliary block glaucoma is a rare complication in patients with pre-existing glaucoma.
  • It is caused by misdirected aqueous fluid, leading to anterior chamber shallowing.
  • Refractory cases often necessitate pars plana vitrectomy.

Purpose of the Study:

  • To evaluate the efficacy of pars plana vitrectomy in treating refractory ciliary block glaucoma.
  • To identify factors influencing treatment success and complications.

Main Methods:

  • Retrospective review of 21 patients with refractory ciliary block glaucoma treated with pars plana vitrectomy.
  • Data collected included ocular anatomy, glaucoma history, prior surgeries, and outcomes.

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Main Results:

  • Pars plana vitrectomy successfully alleviated ciliary block in 70% of eyes (14/20).
  • Phakic eyes that failed initial vitrectomy (5/6) often required additional surgery.
  • Complications included cataract formation, retinal detachment, and bleb failure.

Conclusions:

  • Pars plana vitrectomy is a valuable treatment for refractory ciliary block glaucoma unresponsive to medical or laser therapy.
  • The primary surgical goal is to re-establish normal aqueous flow by removing the anterior hyaloid.
  • Surgical success can be challenged by poor visualization and the need to protect ocular structures.