Malignant glaucoma after cataract surgery

Varma, Devesh; Belovay, Graham W.; Tam, Diamond Y.; Ahmed, Iqbal Ike K.

doi:10.1016/j.jcrs.2014.02.045

Cited by 36 publications

(26 citation statements)

References 9 publications

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“…The most frequent complication (five eyes) was posterior capsule rupture, which is also the most common complication during cataract surgery, reported with similar frequency in other studies [16]. Postoperative malignant glaucoma (diagnosed in three study eyes) is a pathological condition, the higher incidence is associated with a narrow or closed angle, shallow anterior chamber, and hyperopia [17].…”

Section: Discussionsupporting

confidence: 63%

Evaluation of efficacy of lens extraction for intraocular pressure reduction in eyes with primary angle closure glaucoma and primary angle closure

2017

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introduCtion. The purpose of the study was to evaluate the intraocular pressure (IOP) lowering effect of lens removal in eyes with primary angle closure glaucoma (PACG) and primary angle closure (PAC). MATERIALS AND METHODS. This study was a retrospective analysis of 114 eyes of 97 patients (83 women, 14 men; mean age 69.9 years) with PACG and PAC treated with lens extraction. Outcome measures: age, gender, visual acuity, IOP reduction over time, preoperative and postoperative number of IOP-lowering medications, axial length, intraocular lens (IOL) power, requirement for additional anti-glaucoma operations, and complications. Patients were divided into three groups: 1) patients with PAC (22 eyes) with mean follow-up 12.2 months; 2) patients with PACG with a history of previous acute angle closure (AAC) (39 eyes) with mean follow-up 15.4 months; and 3) patients with PACG without a history of previous AAC (53 eyes), with mean follow-up 13.5 months. Laser iridotomy was performed in all treated eyes prior to the surgery. RESULTS. In the group with PAC mean IOP was reduced from 42.2 ± 15.4 mm Hg (mean ± SD) under 2.6 IOP-lowering medications to 20.2 ± 10.4 mm Hg under 1.1 IOP-lowering medications (mean IOP reduction 52.1%). In the group with PACG with a history of previous AAC mean IOP was reduced from 29.0 ± 15.7 mm Hg under 2.1 IOP-lowering medications to 17.0 ± 7.5 mm Hg under 0.7 IOP-lowering medications (mean IOP reduction 41.3%). In the group with PACG without a history of previous AAC (53 eyes) mean IOP was reduced from 22.8 ± 8.0 mm Hg under 1.75 IOP-lowering medications to 18.8 ± 7.4 mm Hg under 1.5 IOP-lowering medications (mean IOP reduction 17.5%). In all three groups statistically significant improvement of visual acuity as a result of surgery was observed. There were no statistically significant differences between the three groups with regard to AXL or IOL power. Intraoperative complications were noticed in eight cases, and postoperative complications were noticed in four cases. The number of anti-glaucoma medications was reduced, but 17 eyes needed additional anti-glaucoma procedures. CONCLUSIONS. Lens extraction in eyes with PACG and PAC resulted in significant IOP reduction in all groups. The most pronounced IOP reduction was achieved in the group with PAC, where lens extraction was performed up to 60 days from AAC. Visual acuity was significantly improved as a result of surgery in all three study groups.

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Section: Discussionsupporting

confidence: 63%

Evaluation of efficacy of lens extraction for intraocular pressure reduction in eyes with primary angle closure glaucoma and primary angle closure

2017

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“…Although this technique corrected the underlying pressure imbalance, residual angle damage necessitated the continuation of medical management in case 3. 2 In this case, the continuation of medical management was necessary while still reducing the burden of polypharmacy.…”

Section: Discussionmentioning

confidence: 95%

“…Aqueous misdirection, reported by von Graefe in 1869, describes an uncommon finding occurring in up to 6% of cases after incisional ocular surgeries. 1,2 It is characterized by a shallow peripheral and central anterior chamber depth (ACD), forward displacement of the lens-irisdiaphragm, and normal-to-elevated intraocular pressures (IOPs) in the absence of pupillary block or suprachoroidal hemorrhage. 3 An abnormal anatomic relationship between ciliary processes, lens, and anterior hyaloid accumulates aqueous posterior to the ciliary body and anterior hyaloid causing anterior displacement of the lens-iris-diaphragm, resulting in narrow angles and a myopic shift in vision.…”

Section: Aqueous Misdirection Masked As Myopia After Cataract Surgerymentioning

confidence: 99%

Aqueous misdirection masked as myopia after cataract surgery

Moinul

Luong

Bhamra

et al. 2017

Canadian Journal of Ophthalmology

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“…Interessanterweise wird nur selten von einer Myopisierung beim Auftreten eines malignen Glaukoms berichtet [6,7,9]. Wie in unserem Fall kann sie jedoch sowohl zur Diagnose als auch zur Kontrolle des Therapieerfolgs beim malignen Glaukom von Bedeutung sein (.…”

Section: Introductionunclassified

Chronifiziertes malignes Glaukom nach Kataraktoperation

et al. 2020

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Chronifiziertes malignes Glaukom nach Kataraktoperation Anamnese Eine 83-jährige Patientin stellte sich Ende 2018 laut Überweisung wegen Tensioentgleisung und neu diagnostiziertem Gesichtsfeldausfall an ihrem linken Auge (LA) in unserer augenärztlichen Ambulanz vor. Die Patientin schilderte, links wie durch einen Schleier zu sehen, welcher schleichend aufgetreten sei und langsam zugenommen habe. Anamnestisch sei das LA seit der Kataraktoperation an beiden Augen 2011 nie so gut gewesen wie das rechte Auge (RA). Weitere ophthalmologische Vordiagnosen bestünden nicht. Ein Trauma sei nicht erinnerlich. Befund Bei Erstvorstellung lag der Visus am LA bei 0,1, am RA bei 0,8. Im Vergleich zu den Refraktionswerten der eigenen Brille (RA:-0,5-1 115°, LA:-2-0,25 114°) zeigte sich in der durchgeführten Autorefraktion eine deutliche Abweichung am Abb. 1 9 Ausgangsbefund des rechten (a) und linken (b) Auges und Befund nach 1 Woche Therapie (rechts c, links d) in der Ultraschallbiomikroskopie (Lin-50, 100 dB, 50 MHz, Axialschnitt, Quantel Medical, Cournon d'Auvergne, Frankreich) Der Ophthalmologe Abb. 2 8 Spectralis-OCT mit RNFL-Darstellung des RA (a) und LA (b) bei Erstvorstellung Abb. 3 8 Gesichtsfeldbefund in der Goldmann-Perimetrie am LA bei Erstvorstellung

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Malignant glaucoma after cataract surgery

Abstract: No author has a financial or proprietary interest in any material or method mentioned.

Cited by 36 publications

References 9 publications

Evaluation of efficacy of lens extraction for intraocular pressure reduction in eyes with primary angle closure glaucoma and primary angle closure

Evaluation of efficacy of lens extraction for intraocular pressure reduction in eyes with primary angle closure glaucoma and primary angle closure

Aqueous misdirection masked as myopia after cataract surgery

Chronifiziertes malignes Glaukom nach Kataraktoperation

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