Ciliary block or malignant glaucoma is thought to be caused by the misdirection of aqueous into the vitreous. It is refractory to medical treatment and often requires vitreous aspiration. We present a case of ciliary block glaucoma caused by sodium chondroitin sulfate-sodium hyaluronate (Viscoat) gaining access to the vitreous through an unsuspected, small zonular dialysis. Vitrectomy performed through a peripheral iridectomy resolved this severe condition.

U.G.H. syndrome is a known complication of IOL implantation associated with the use of anterior and rarely, posterior chamber intraocular lenses. It is due to mechanical excoriation of the angle or iris by the haptics or optic of an IOL and consists of uveitis, glaucoma and hyphema (U.G.H.). The advised therapeutic approach is explantation of the IOL. Following implantation of a posterior chamber IOL, three patients presented with bleeding into the posterior chamber, one associated with glaucoma. No patient had signs of uveitis. We decided to address the symptoms and not to explant the IOL. We believe that this constitutes a variant of the 'classical' U.G.H. syndrome, namely an incomplete posterior U.G.H. (I.P.U.G.H.) syndrome, in which explanation of the I.O.L. is not compulsory.

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The management of congenital cataracts is still challenging, especially in developing nations, where surgical facilities are limited. Congenital cataracts were extracted from 22 patients (26 eyes): a procedure consisting of a star-shaped anterior capsulectomy and wash-out of lens material (STARWO) was performed in 16 of them (18 eyes) (group A); a procedure consisting of a star-shaped anterior capsulectomy, wash-out, anterior vitrectomy through the posterior capsulotomy, and repeated tearing of remnants of the anterior capsule (STARWAR) was performed in six patients (eight eyes) (group B). Intraocular lenses were implanted in both groups. In group A, secondary membranes (27.7%) developed in five eyes, postoperative uveitis in four (22.2%), and a late Elschnig pearl in 1 (5.5%). In group B, there was one case of secondary membrane formation (12.5%), and one of postoperative uveitis; neither required subsequent intervention. The inexpensive instrumentation used and the low rate of perioperative complications encountered in these patients make these two techniques attractive alternatives for managing congenital cataracts in developing nations.