J Glaucoma
J GlaucomaMarch 2019Case Reports

Malignant Glaucoma After Laser Peripheral Iridotomy.

IOP & Medical TherapyAngle & Aqueous Outflow

Summary

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.

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.

Discussion

Comments and discussion will appear here in a future update.