Retrospective clinical analysis of 118 cases with malignant glaucoma

Abstract

To study the clinical characteristics and pathogenesis of malignant glaucoma in a 5-year retrospective analysis in Zhongshan Ophthalmic Center (ZOC). Medical records of 5-year malignant glaucoma patients in Zhongshan Ophthalmic Center were reviewed retrospectively. Patients' age, gender, original disease, duration before attack, axial length and the change of depth of anterior chamber, intraocular pressure and visual acuity before and after therapy and at final follow-up were checked and analyzed. One hundred and eighteen cases of malignant glaucoma were hospitalized in ZOC from April 2005 to March 2010, accounts for 2.17% of PACG patients. Average age of malignant glaucoma patients was lower than that of PACG patients. The mean axial length of malignant glaucoma patients was shorter than that of Chinese population. Malignant glaucoma attacked between 1 day and 4.5 years after surgery. Ninety-three percent patients required medication and surgeries. Lens extraction and anterior vitrectomy were more effective than anterior chamber reforming combined with vitreous aspiration. The mean age of failed patient with vitreous cavity suction combined with anterior chamber angioplasty surgery was (43.7 ± 4.8) years, and was significantly younger than succeed patients, (53.7 ± 12.6) years (P < 0.05). Malignant glaucoma are iatrogenic and nine tenths secondary to surgeries of PACG patients. Topical application of atropine is the first choice of medication. Lens extraction combined with anterior vitrectomy has more privileges, however, is not commended especially for younger patients.