A 50-year-old woman developed malignant glaucoma after a peripheral iridectomy for chronic angle-closure glaucoma. Treatment with atropine, phenylephrine hydrochloride, acetazolamide, and intravenously administered mannitol failed to lower the tension and form the anterior chamber. Vitreous puncture and aspiration and air injection into the anterior chamber relieved the malignant glaucoma, the anterior chamber formed, and tension fell. Later in the postoperative period tension rose. It was first controlled with epinephryl borate 1%, but later required pilocarpine 2% four times a day to control tension. Pilocarpine was well tolerated and did not cause a recurrence of malignant glaucoma.
Macoul KL. Residual Glaucoma and MioticsTreatment After Relief of Malignant Glaucoma by Vitreous Puncture and Aspiration. Arch Ophthalmol. 1972;88(2):210-211. doi:10.1001/archopht.1972.01000030212017