A treatment algorithm of medication, laser hyaloidotomy, and vitrectomy or transscleral cyclophotocoagulation was successful in managing malignant glaucoma, according to a study.
The retrospective case series comprised 28 eyes that were treated for malignant glaucoma between 1991 and 2009. Five eyes were phakic, and 23 were pseudophakic. Diagnosis was based on IOP of 22 mm Hg or more after intraocular surgery and a shallow or flat anterior chamber with a patent iridotomy.
Malignant glaucoma resolved in 27 eyes (96%), with 17 resolved with one intervention and 10 eyes needing repeat procedures. Four eyes resolved with medical treatment, seven pseudophakic eyes resolved with laser hyaloidotomy, four eyes resolved with vitrectomy with hyaloidotomy and iridectomy, and 12 eyes resolved with transscleral cyclophotocoagulation.
IOP was significantly reduced at final follow-up, but there was no significant difference in visual acuity.
The study authors said medical treatment helped resolve malignant glaucoma in phakic eyes with a short duration of presentation.