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June 1998

Options in the Management of Malignant Glaucoma

Arch Ophthalmol. 1998;116(6):799-800. doi:10.1001/archopht.116.6.799

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.

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