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      Slit-lamp Pars Plana Needle Hyaloidotomy-Zonulotomy-Iridotomy for the Treatment of Spontaneous Malignant Glaucoma.

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          Abstract

          An 88-year-old woman with a history of recent complicated pacemaker insertion presented with acute-onset malignant glaucoma recalcitrant to conservative medical therapy. Surgical intervention was discussed; however, given her complex cardiac history and recent postoperative state, the risk of anesthesia-related systemic adverse events was deemed unacceptably high. As such, a slit-lamp procedure was recommended to break the attack of malignant glaucoma. Here within, we report a novel technique of breaking an attack of malignant glaucoma by needling the anterior hyaloid face at the slit lamp. With this technique, a 25-G needle was entered through the pars plana and was advanced through the anterior hyaloid face, zonules, and peripheral iridotomy to create a unicameral eye and successfully break the malignant closure attack.

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          Author and article information

          Journal
          J Glaucoma
          Journal of glaucoma
          Ovid Technologies (Wolters Kluwer Health)
          1536-481X
          1057-0829
          May 2020
          : 29
          : 5
          Affiliations
          [1 ] Department of Ophthalmology, Casey Eye Institute, Oregon Health and Science University, Portland, OR.
          [2 ] Department of Ophthalmology and Visual Sciences, University of Iowa, Iowa City, IA.
          [3 ] Department of Ophthalmology and Visual Sciences, Kellogg Eye Center, University of Michigan, Ann Arbor, MI.
          Article
          00061198-202005000-00015
          10.1097/IJG.0000000000001473
          32097257
          ac5c39c0-7a5a-40ce-a9c3-950deeb1e15d
          History

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