Malignant Glaucoma After Laser Peripheral Iridotomy

J Glaucoma. 2019 Mar;28(3):e44-e45. doi: 10.1097/IJG.0000000000001145.

Abstract

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.

Publication types

  • Case Reports
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Anterior Chamber / diagnostic imaging
  • Anterior Chamber / pathology*
  • Glaucoma, Angle-Closure / etiology
  • Glaucoma, Angle-Closure / surgery*
  • Gonioscopy
  • Humans
  • Intraocular Pressure / physiology
  • Iridectomy / adverse effects*
  • Iris / surgery*
  • Laser Therapy / methods
  • Lasers, Solid-State / therapeutic use
  • Male
  • Microscopy, Acoustic
  • Middle Aged
  • Myopia / etiology
  • Postoperative Complications*
  • Tomography, Optical Coherence
  • Tonometry, Ocular
  • Vitrectomy