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September 1962

Taking the Malignancy Out of Malignant Glaucoma

Arch Ophthalmol. 1962;68(3):301. doi:10.1001/archopht.1962.00960030305001

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Persistently shallow or flat anterior chamber with continued elevation of the intraocular pressure has been one of the more dreaded complications of glaucoma surgery. First called malignant glaucoma by von Graefe (1869), it occurs in about 2% of operations in cases of angle-closure glaucoma in which the tension is either elevated at the time of surgery or in which the effects of angle closure are masked by acetazolamide (Diamox) or urea. Occurring in one eye, it will almost certainly occur in the other eye if it is operated on under similar conditions. Thus it has been one of the major failures in glaucoma therapy and a not infrequent cause of blindness.

Malignant glaucoma can be prevented if a peripheral iridectomy is done at a time when the tension is normal. This is the obvious treatment of choice in the second eye of a patient who is known to have had

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