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Outcomes of different management options for malignant glaucoma: a retrospective study

  • Glaucoma
  • Published:
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Abstract

Background

To assess the outcomes of the various medical and surgical treatment options for malignant glaucoma.

Methods

Design Retrospective, comparative case series.

Participants Twenty-four eyes of 21 patients with malignant glaucoma.

Intervention Nine eyes were treated medically. Twenty-one eyes underwent surgery, 15 of which had the full vitrectomy–(phaco)–iridectomy–zonulectomy procedure.

Main outcome measures Intraocular pressure (IOP), best-corrected visual acuity (BCVA) and number of glaucoma medications were measured.

Results

The relapse rate was 100% after medical therapy, 75% after a Yag laser capsulotomy and a hyaloidotomy, 75% after a conventional vitrectomy and 66% after an anterior vitrectomy in combination with an iridectomy–zonulectomy. All patients who underwent a full vitrectomy combined with an iridectomy and a zonulectomy (and phacoemulsification if phakic) had postoperative relief of malignant glaucoma without relapse within the follow-up period. After this vitrectomy-tunnel technique, the IOP ranged from 10 to 22 mmHg (mean 16 mmHg) after a mean follow-up of 61 days. Mean BCVA improved by 5 Early Treatment Diabetic Retinopathy Study (ETDRS) lines, and mean number of glaucoma medications decreased from two to one.

Conclusion

Complete vitrectomy combined with iridectomy and zonulectomy (and phacoemulsification, if applicable) most successfully managed aqueous misdirection syndrome in our retrospective case series.

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Acknowledgments

Disclosure

The authors have no financial relationship with any organization and have no sponsoring to disclose.

The authors have no conflicts of interest with respect to this work.

This work has not been presented at a conference.

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Authors and Affiliations

  1. Department of Ophthalmology, Kapucijnenvoer 33, 3000, Leuven, Belgium

    Veroniek Debrouwere, Peter Stalmans, Joachim Van Calster, Werner Spileers, Thierry Zeyen & Ingeborg Stalmans

Authors
  1. Veroniek Debrouwere
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  2. Peter Stalmans
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  3. Joachim Van Calster
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  4. Werner Spileers
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  5. Thierry Zeyen
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  6. Ingeborg Stalmans
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Corresponding author

Correspondence to Ingeborg Stalmans.

Additional information

The authors have full control of all primary data, and they agree to allow Graefe’s Archive for Clinical and Experimental Ophthalmology to review their data upon request.

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Debrouwere, V., Stalmans, P., Van Calster, J. et al. Outcomes of different management options for malignant glaucoma: a retrospective study. Graefes Arch Clin Exp Ophthalmol 250, 131–141 (2012). https://doi.org/10.1007/s00417-011-1763-0

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  • DOI: https://doi.org/10.1007/s00417-011-1763-0

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