Current Concepts on Aqueous Misdirection

Malignant glaucoma presenting with uncontrolled intraocular pressure and myopic refractive surprise after cataract surgery

“… 7 Pars plana vitrectomy when combined with pharmacotherapy has proven to be effective as a conservative measure, especially in pseudophakic eyes. 8 However, due to the complex nature and pathogenesis of malignant glaucoma, in many cases, conservative treatment may prove to be inadequate. In retrospective studies, relapse proved to be as high as 100% after medical therapy and up to 75% after vitrectomy.…”

“…In retrospective studies, relapse proved to be as high as 100% after medical therapy and up to 75% after vitrectomy. 8 However, with continuous advancements in surgical techniques, prognosis is relatively good in most cases. In patients where further intervention is required, often a pragmatic goal is to achieve a unicameral eye and allow for communication of aqueous fluid from the posterior to anterior segment.…”

“…In patients where further intervention is required, often a pragmatic goal is to achieve a unicameral eye and allow for communication of aqueous fluid from the posterior to anterior segment. 8 Treatment modalities can vary slightly depending on whether the patient presents with phakic or pseudophakic eyes based on suggested algorithms. In treatment‐resistant phakic eyes, lens or cataract extraction, posterior capsulotomy and anterior vitrectomy are typically advisable treatments.…”

“…Medical therapy includes cycloplegic agents such as atropine and hyperosmotics such as mannitol and acetazolamide, alleviating ciliary block and shrinking the vitreous body, respectively 7 . Pars plana vitrectomy when combined with pharmacotherapy has proven to be effective as a conservative measure, especially in pseudophakic eyes 8 . However, due to the complex nature and pathogenesis of malignant glaucoma, in many cases, conservative treatment may prove to be inadequate.…”

“…However, due to the complex nature and pathogenesis of malignant glaucoma, in many cases, conservative treatment may prove to be inadequate. In retrospective studies, relapse proved to be as high as 100% after medical therapy and up to 75% after vitrectomy 8 . However, with continuous advancements in surgical techniques, prognosis is relatively good in most cases.…”