IN THIS ISSUE of the ARCHIVES, Azuara-Blanco and colleagues1 describe 2 cases of malignant glaucoma complicated by extensive angle closure with probable peripheral anterior synechiae and markedly elevated intraocular pressure (IOP). Their criteria for the diagnosis of malignant glaucoma are sound: patent peripheral iridotomies, shallow chambers (axial depth), and the absence of ciliary or choroidal effusions. Treatment of malignant glaucoma does not usually require a tube shunt, as extensive synechial angle closure does not always accompany the condition. Their use of a Baerveldt shunt in conjunction with pars plana vitrectomy, although successful, represents an aggressive management option. Other therapies are possible, as discussed below.
Johnson DH. Options in the Management of Malignant Glaucoma. Arch Ophthalmol. 1998;116(6):799–800. doi:10.1001/archopht.116.6.799