Pars plana vitrectomy in the management of phakic and pseudophakic malignant glaucoma. 1996

J W Harbour, and P E Rubsamen, and P Palmberg
Bascom Palmer Eye Institute, Department of Ophthalmology, University of Miami School of Medicine, Fla.

OBJECTIVE To determine the indications for and outcome of pars plana vitrectomy in the management of phakic and pseudophakic malignant glaucoma. METHODS Retrospective review. METHODS Tertiary referral ophthalmic hospital. METHODS Twenty-two patients (24 eyes) who underwent pars plana vitrectomy in the management of malignant glaucoma. RESULTS Fourteen eyes were phakic and 10 were pseudophakic at the initial vitrectomy. The primary indication for vitrectomy was failure of other therapies. In phakic eyes, the initial vitrectomy was successful in terminating malignant glaucoma without further surgery in 7 (100%) of 7 eyes that underwent lensectomy and in 5 (71%) of 7 eyes that not did not undergo lensectomy. The primary indication for lensectomy was corneal edema caused by lens-corneal touch. In pseudophakic eyes, the initial vitrectomy was successful in 9 (90%) of 10 eyes. Removal of the intraocular lens was performed in 1 eye. Perioperative complications included transient serous choroidal detachment in 2 eyes, transient exudative retinal detachment in 1 eye, and suprachoroidal hemorrhage in 1 eye. CONCLUSIONS Pars plana vitrectomy is effective in treating phakic and pseudophakic malignant glaucoma. Success is contingent on establishing a pathway for aqueous flow into the anterior chamber, which usually is accompanied by intraoperative deepening of the anterior chamber. In phakic eyes, lensectomy may be considered for marked corneal edema, for dense cataract, or when the anterior chamber will not deepen during vitrectomy.

UI MeSH Term Description Entries
D007429 Intraocular Pressure The pressure of the fluids in the eye. Ocular Tension,Intraocular Pressures,Ocular Tensions,Pressure, Intraocular,Pressures, Intraocular,Tension, Ocular,Tensions, Ocular
D007908 Lens, Crystalline A transparent, biconvex structure of the EYE, enclosed in a capsule and situated behind the IRIS and in front of the vitreous humor (VITREOUS BODY). It is slightly overlapped at its margin by the ciliary processes. Adaptation by the CILIARY BODY is crucial for OCULAR ACCOMMODATION. Eye Lens,Lens, Eye,Crystalline Lens
D007910 Lenses, Intraocular Artificial implanted lenses. Implantable Contact Lens,Lens, Intraocular,Contact Lens, Implantable,Intraocular Lens,Intraocular Lenses,Lens, Implantable Contact
D008297 Male Males
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D002387 Cataract Extraction The removal of a cataractous CRYSTALLINE LENS from the eye. Enzymatic Zonulolysis,Phakectomy,Cataract Extractions,Enzymatic Zonulolyses,Extraction, Cataract,Extractions, Cataract,Phakectomies,Zonulolyses, Enzymatic,Zonulolysis, Enzymatic
D005260 Female Females
D005902 Glaucoma, Open-Angle Glaucoma in which the angle of the anterior chamber is open and the trabecular meshwork does not encroach on the base of the iris. Glaucoma Simplex,Glaucoma, Pigmentary,Glaucoma, Simple,Open-Angle Glaucoma,Chronic Primary Open Angle Glaucoma,Glaucoma, Compensated,Glaucoma, Compensative,Glaucoma, Open Angle,Glaucoma, Primary Open Angle,Glaucoma, Secondary Open Angle,Primary Open Angle Glaucoma,Secondary Open Angle Glaucoma,Compensated Glaucoma,Compensative Glaucoma,Open Angle Glaucoma,Open Angle Glaucomas,Open-Angle Glaucomas,Pigmentary Glaucoma,Simple Glaucoma,Simplex, Glaucoma,Simplices, Glaucoma
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000328 Adult A person having attained full growth or maturity. Adults are of 19 through 44 years of age. For a person between 19 and 24 years of age, YOUNG ADULT is available. Adults

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