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The management of malignant glaucoma involves either anterior vitrectomy with zonulectomy and iridectomy or 3-port core pars plana vitrectomy (PPV) by retinal surgeons. The proposed modification can be performed with reasonable success rates. In this technique, synechiolysis and anterior chamber irrigation is performed through a limbal incision, and a single-port 23- or 25-gauge vitrector is introduced through PPV superotemporally to perform anterior vitrectomy and central posterior capsulotomy in pseudophakic eyes. The same procedure can be performed after cataract surgery in phakic eyes. Vitrectomy is continued until anterior chamber deepens, ensuring a conduit between anterior and posterior chambers through the posterior capsulotomy alone, bypassing the need for a posterior iridectomy/zonulectomy. In a series on 9 eyes, all achieved optimization of anterior chamber depth with IOP normalization in 8 of 9 eyes without showing any signs of recurrence at a mean follow-up of 8.6 months.
From the Dr Rajendra Prasad Center for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India (S. Gupta, Lakra, Beniwal, Chawla, V. Gupta); Iclinix Advanced Eye Care, New Delhi, India (Gogia).
Full article9.4.11.1 Ciliary block (malignant) glaucoma (Part of: 9 Clinical forms of glaucomas > 9.4 Glaucomas associated with other ocular and systemic disorders > 9.4.11 Glaucomas following intraocular surgery)
12.16 Vitrectomy (Part of: 12 Surgical treatment)