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Case Report

Challenging Management of Spontaneous Malignant Glaucoma with Combined Surgical Intervention and Therapy - A Rare Case Report

Clara Valentina, Ni Kompyang Rahayu, I Ketut Semara, Cindy Hartono.

This article aims to report a rare case of spontaneous malignant glaucoma in Asian female and its challenging management by combined surgical interventions and anti-glaucomatous therapy.
Case presentation
A 47 years old Asian female was diagnosed of glaucoma on both eyes since one year before admission and has had uncontrolled history of medication. She had absolute glaucoma on the left eye with visual acuity of no light perception (NLP) and was recently diagnosed with spontaneous malignant glaucoma and immature cataract on the right eye. In this phakic patient, combined surgical methods of phacoemulsification+IOL (Intra Ocular Lens), peripheral iridotomy, full vitrectomy, and posterior capsulotomy was successful in treating malignant glaucoma. Final intraocular pressure (IOP) could be controlled at 14 mmHg and visual acuity (VA) of 6/18.
Multiple prompt and aggressive treatments are keys to prevent permanent blindness. No recurrence was observed within 3 months of follow-up period. No significant complication occurred during intra- and post-operative periods. The prognosis of this condition is good with the currently available treatment modalities.

Key words: Aqueous misdirection, malignant glaucoma, phakic, spontaneous onset, pars plana vitrectomy, peripheral iridectomy

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