J Korean Ophthalmol Soc.  2010 Aug;51(8):1150-1154.

A Case of Malignant Glaucoma-like Phenomenon During Cataract Surgery

• Lee SY
• Park JW

Abstract

PURPOSE
Malignant glaucoma is a rare complication of anterior segment surgery. The authors present a case of a malignant glaucoma-like phenomenon during cataract surgery in a primary open-angle glaucoma (POAG) patient.
CASE SUMMARY
A 74-year-old man with POAG underwent a cataract surgery in his left eye. After phacoemulsificiation, sodium hyaluronate was used to form the capsular bag for intraocular lens implantation. Following this procedure, the capsular bag space and anterior chamber became shallow. Intraocular pressure (IOP) elevated, and the shallowing of the anterior chamber and capsular bag space continued to a dangerous level. The surgical procedure was stopped and postponed for two days. After two days, IOL was successfully implanted in the posterior bag.
CONCLUSIONS
Although the preoperative ophthalmologic examination failed to reveal a zonular problem, there was a possibility for a small area of zonular defect. A malignant glaucoma-like phenomenon was suspected to have occurred due to leakage of sodium hyaluronate or balanced salt solution into the vitreous through a small area of zonular dialysis. If a similar condition, occurs delayed surgery for IOL implantation would be more effective than vitrectomy or laser treatment.

Keyword

Cataract surgery; Hyaluronate sodium; Malignant glaucoma; Zonular dialysis

MeSH Terms

Aged
Anterior Chamber
Cataract
Dialysis
Eye
Glaucoma
Glaucoma, Open-Angle
Humans
Hyaluronic Acid
Intraocular Pressure
Lens Implantation, Intraocular
Vitrectomy
Hyaluronic Acid

Figure

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  Figure 1. Shallow capsular bag space (A). Shallow capsular bag space did not distend by sodium hyaluronate injection (B).

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  Figure 2. Careful sodium hyaluronate injection restored the capsular bag space (Enough space for intraocular lens insertion).

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  Figure 3. IOL was successfully implanted in the posterior bag.

Reference

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