Abstract #80548 Published in IGR 20-3

Malignant Glaucoma After Laser Peripheral Iridotomy

Greenfield JA; Smiddy WE; Greenfield DS
Journal of Glaucoma 2019; 28: e44-e45

PURPOSE: We describe a patient with primary angle-closure glaucoma who developed malignant glaucoma following laser peripheral iridotomy. METHODS: A 58-year-old male presented with peripheral and central anterior chamber shallowing following an uncomplicated Nd: YAG laser peripheral iridotomy. Intraocular pressure (IOP) and B-scan echography were normal, and there was -1.5 Ddiopter asymmetric myopia. Despite treatment with aqueous suppression and cycloplegia for 7 months, the patient developed progressive myopic shift and anterior chamber shallowing. RESULTS: The patient underwent 23-G pars plana vitrectomy and lensectomy using a standard 3-port technique, and sulcus posterior chamber intraocular lens implantation in the left eye. Twelve months postoperatively, the anterior chamber has remained deep, best-corrected visual acuity is 20/15, and the IOP is 11 mm Hg. CONCLUSIONS: Malignant glaucoma is a rare complication of laser iridotomy and should be considered in eyes with progressive anterior chamber shallowing and myopia despite normal IOP.

Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Palm Beach Gardens, FL.

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Classification: Ciliary block (malignant) glaucoma (Part of: 9 Clinical forms of glaucomas > 9.4 Glaucomas associated with other ocular and systemic disorders > 9.4.11 Glaucomas following intraocular surgery)
12.2 Laser iridotomy (Part of: 12 Surgical treatment)

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