[Phacolytic and hemolytic glaucoma (author's transl)]

Clinical and histological data of four patients with acute secondary open-angle glaucoma are described. These included two hemolytic and one phacolytic glaucoma. Another patient showed a transition of hemolytic to a hemosiderotic glaucoma. The hemolytic glaucoma follows a hemorrhage of the vitreous, it is characterised by an open-angle with red-brown pigment deposits on the trabecular meshwork. Macrophages can be isolated from the aqueous humor by zentrifugation. The same macrophages and fragments of lysed red blood cells are histologically visible in the vitreous as well as in the anterior chamber and the trabecular meshwork. The cause of the large vitreous hemorrhage is often a retinal detachment. The hemolytic glaucoma must be clearly distinguished from hemosiderotic and neovascular glaucoma. A transition from hemolytic to hemosiderotic glaucoma is possible. The simultaneous description of hemolytic and phacolytic glaucoma follows by reason of the same pathogenetic mechanism. The treatment of hemolytic glaucoma follows the standard medical therapy of glaucoma. If this therapy will be unsuccessful, a paracentesis with irrigation of the anterior chamber may be required. The only therapy of phacolytic glaucoma is immediate intracapsular cataract extraction.