A Case of Pseudophakic Malignant Glaucoma

ABSTRACT

PURPOSE: Malignant glaucoma is a rare secondary glaucoma characterized by a flat anterior chamber with increased intraocular pressure (IOP). It may occur after intraocular surgery, trauma, inflammation, the use of miotic agents, and so on. We report a case of malignant glaucoma after uncomplicated phacoemulsification with foldable intraocular lens implantation (IOL) using scleral tunnel incision. METHODS: A 74-year-old woman underwent a phacoemulsification with foldable IOL implantation in her left eye. Ten days after cataract surgery, she had severe ocular pain, a high IOP, and a flat anterior chamber. Pupillary block was suspected, and a peripheral iridectomy was done. But she was referred to our hospital for evaluation of persistent IOP elevation with flat anterior chamber. A diagnosis of pseudophakic malignant glaucoma was made, and we performed a core vitrectomy through peripheral iridectomy site. The anterior chamber deepened postoperatively with control of IOP. On the fourth postoperative day, she developed flattening of the anterior chamber with IOP elevation. A recurrence of malignant glaucoma was diagnosed, and anterior vitrecomy with a widening of previous iridectomy wound was done. RESULTS: Postoperatively, the patient had normal IOP, a deep anterior chamber and improved visual acuity. We got successful results from a surgical anterior vitrecomy through peripheral iridectomy site.