Abstract
Purpose
To assess outcomes of surgical management of malignant glaucoma in terms of re-formation of anterior chamber
Methods
This was a retrospective analysis of consecutive patients who underwent surgical treatment for malignant glaucoma between January 1995 and December 2013 at a tertiary care ophthalmic institute, with a minimum follow up of 2 months.
Results
Fifty eight eyes of 58 patients were included. Fifty two (89.7%) patients had primary angle closure glaucoma. The majority had undergone glaucoma filtration surgery earlier (n=53, 91.4%). Lensectomy and anterior vitrectomy was performed in 15 (25.9%) eyes (Group 1). Vitrectomy and anterior chamber re-formation was performed in 27 (46.6%) eyes (Group 2). Vitrectomy-phacoemulsification-vitrectomy was performed in 16 (27.6%) eyes (Group 3). Communication between the two segments of eye through anterior hyaloid, lens capsule complex and/or iris was achieved in all groups. The median follow-up (Inter-quartile range) was 30 (71.5) months. Anterior chamber re-formation was achieved in 56 (96.5%) eyes at final visit. The improvement in mean±SD LogMAR visual acuity (1.1±1 to 0.7±0.8) and reduction in number ±SD of anti-glaucoma medications (2.1±1.1 to 1±1.6) between onset and final visit were significant (P=0.02 and <0.01, respectively). The intraocular pressure (mm Hg) at onset and at final visit was 30.7±17.4 and 14±6.2, 32.8±12.6 and 15.3±7.4, and 27.2±14 and 10.9±3 in groups 1–3, respectively (all P<0.01).
Conclusion
Our anatomical success rate was high. The key element in achieving this outcome was the establishment of a patent communication between the vitreous cavity and the anterior chamber.
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Acknowledgements
We thank Natarajan Viswanathan for statistical assistance. Drs Shantha Balekudaru and Nikhil Choudhari contributed equally to the preparation of the manuscript.
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Balekudaru, S., Choudhari, N., Rewri, P. et al. Surgical management of malignant glaucoma: a retrospective analysis of fifty eight eyes. Eye 31, 947–955 (2017). https://doi.org/10.1038/eye.2017.32
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DOI: https://doi.org/10.1038/eye.2017.32
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