A case of bilateral pseudophakic malignant glaucoma treated with a new variant of irido-zonulo-hyaloid-vitrectomy

Roberto Tosi; Raphael Kilian; Clara Rizzo; Camilla Pagnacco; Giorgio Marchini

doi:10.1016/j.ajoc.2022.101719

A case of bilateral pseudophakic malignant glaucoma treated with a new variant of irido-zonulo-hyaloid-vitrectomy

Am J Ophthalmol Case Rep. 2022 Oct 4:28:101719. doi: 10.1016/j.ajoc.2022.101719. eCollection 2022 Dec.

Authors

Roberto Tosi¹, Raphael Kilian¹, Clara Rizzo¹, Camilla Pagnacco¹, Giorgio Marchini¹

Affiliation

¹ Ophthalmic Unit, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, 37129, Verona, Italy.

Abstract

Purpose: To describe a case of bilateral pseudophakic malignant glaucoma treated with a new variant of irido-zonulo-hyaloid-vitrectomy.

Observations: A patient who developed refractory bilateral pseudophakic malignant glaucoma underwent an irido-zonulo-hyaloid-vitrectomy via the anterior chamber in both eyes, one 2-months apart from the other. The procedure involved the use of an 18 Gauge needle to perform a straight vertical irido-zonulo-hyaloidotomy and a 25 Gauge vitreous cutter to complete the vitrectomy. The intraocular pressure was recorded on day 1, day 7, day 14, then monthly until 6 months postoperatively, whereas an ultrasound biomicroscopy of the anterior chamber was performed on day 1 and 6 months after the operation. The malignant glaucoma resolved in both eyes with no intra- nor post-operative complications. At 6 months from the surgeries none of the eyes developed recurrences.

Conclusions: The new variant of irido-zonulo-hyaloid-vitrectomy we propose for the management of refractory pseudophakic malignant glaucoma resulted to be a safe and effective technique.

Keywords: Anterior vitrectomy; Aqueous misdirection; Ciliary block glaucoma; Irido-zonulo-hyaloidotomy; Malignant glaucoma.

Publication types

Case Reports