Repositioning of glaucoma tubes into the pars plana for refractory malignant glaucoma: a case report

Journal of Medical Case Reports

Alice Song¹  Michael Song²  Alessandro Castellarin¹  Julia Song¹ 

[1] Long Beach Memorial Medical Center, 2840 Long Beach Blvd. , #330, Long Beach, CA 90806, USA;California Retina Consultants and Research Foundation, 515 East Micheltorena, Suite C, Santa Barbara, CA 93103, USA

关键词: Tube;    Pars plana vitrectomy;    Pars plana;    Malignant glaucoma;    Ciliary block glaucoma;   

Others  :  1181217
DOI  :  10.1186/1752-1947-7-102

 received in 2012-10-31, accepted in 2013-02-27,  发布年份 2013

【 摘 要 】

Introduction

Malignant glaucoma occurs when the intraocular pressure elevates in the setting of a shallow anterior chamber and patent iridectomy. We describe a case in which malignant glaucoma that was refractory to conventional treatment and complete vitrectomy was successfully managed by rerouting the glaucoma tubes into the pars plana.

Case presentation

A 47-year-old Latino man had a history of neovascular glaucoma and subsequent peripheral anterior synechiae. He was status post-two glaucoma drainage devices. He developed pupillary block. Laser iridotomy was performed without complications. He subsequently developed malignant glaucoma that was refractory to yttrium aluminum garnet capsulohyaloidotomy of the anterior hyaloid. He underwent pars plana vitrectomy with successful control of his intraocular pressure. After 2 weeks, the malignant glaucoma recurred. He underwent repositioning of the tubes into the pars plana with successful control of his intraocular pressure.

Conclusion

In rare cases of malignant glaucoma refractive to yttrium aluminum garnet hyaloidotomy and vitrectomy, placement of glaucoma drainage devices is a reasonable alternative.

【 授权许可】

   
2013 Song et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

【 参考文献 】

• [1]Melamed S, Ashkenazi I, Blumenthal M: Nd-YAG laser hyaloidotomy for malignant glaucoma following one-piece 7 mm intraocular lens implantation. Br J Ophthalmol 1991, 75:501-503.
• [2]Mastropasqua L, Ciancaglini M, Carpineto P, Lobefalo L, Gallenga PE: Aqueous misdirection syndrome: a complication of neodymium: YAG posterior capsulotomy. J Cataract Refract Surg 1994, 20:563-565.
• [3]Arya SK, Sonika , Kochhar S, Kumar S, Kang M, Sood S: Malignant glaucoma as a complication of Nd: YAG laser posterior capsulotomy. Ophthalmic Surg Lasers Imaging 2004, 35:24-50.
• [4]Brown RH, Lynch MG, Tearse JL, Nunn RD: Neodymium-YAG vitreous surgery for phakic and pseudophakic malignant glaucoma. Arch Ophthalmol 1986, 104:1464-1466.
• [5]Lois N, Wong D, Groenewald C: New surgical approach in the management of pseudophakic malignant glaucoma. Ophthalmol 2001, 108:780-783.
• [6]Harbour J, Rubsamen P, Palmberg P: Pars plana vitrectomy in the management of phakic and pseudophakic malignant glaucoma. Arch Ophthalmol 1996, 114:1073-1078.
• [7]Lynch M, Brown R, Michels R, Pollack IP, Stark WJ: Surgical vitrectomy for pseudophakic malignant glaucoma. Am J Ophthalmol 1986, 102:149-153.
• [8]Byrnes GA, Leen M, Wong T, Benson W: Vitrectomy for ciliary block (malignant) glaucoma. Ophthalmol 1995, 102:1308-1311.
• [9]Steinert R, Epstein DL, Puliafito CA: Surgical vitrectomy for pseudophakic malignant glaucoma. Am J Ophthalmol 1986, 102:803-804.
• [10]Seymenoglu RG, Baser EF: Management of pseudophakic malignant glaucoma and ultrasound biomicroscopic features. Can J Ophthalmol 2009, 44:719-720.
• [11]Azuara-Blanco A, Katz L, Gandham S, Spaeth G: Pars plana tube insertion of aqueous shunt with vitrectomy in malignant glaucoma. Arch Ophthalmol 1998, 116:808-810.
• [12]Tsai JC, Khaw PT, Hitchings RA: Management of pseudophakic malignant glaucoma. Ophthalmol 2002, 109:820-821.
• [13]Tsai YY, Tseng SH: Combined trabeculectomy and vitrectomy for pseudophakic malignant glaucoma and extensive peripheral anterior synechia-induced secondary glaucoma. J Cataract Refract Surg 2004, 30:715-717.
• [14]Cekic O, Batman C: Pars plana vitrectomy in the treatment of phakic and pseudophakic malignant glaucoma. Arch Ophthalmol 1998, 116:118.
• [15]Zacharia P, Abboud E: Recalcitrant malignant glaucoma following pars plana vitrectomy, scleral buckle, and extracapsular cataract extraction with posterior chamber intraocular lens implantation. Ophthalmic Surg Lasers 1998, 29:323-327.