Sir,

Intraocular pressure (IOP) elevation is a common complication of pars plana vitreous surgery.1 Acute glaucoma may occur in the postoperative period secondary to angle closure caused by surgical adjuvants such as long-acting expansile gases, silicone oil, and perfluorocarbon liquids; by postoperative inflammation, and by oedema of the ciliary body and anterior rotation of ciliary processes.1,2,3,4 Macular-hole surgery predisposes to angle closure because of prolonged prone positioning and the routine use of cycloplegic agents postoperatively. Since surgery to close a macular hole is a relatively recent innovation, to our knowledge only two cases of angle-closure glaucoma following this surgery have been recorded.5 We report two further cases of acute angle-closure glaucoma following macular-hole surgery in patients with axial hypermetropia, in whom neither symptoms nor signs suggestive of angle closure existed preoperatively.

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