Management of Malignant Glaucoma in a Pseudophakic Silicon Oil-Filled Eye: A case report

Doi: 10.36351/pjo.v41i1.1815

Abstract

This case report describes malignant glaucoma following Ahmed glaucoma valve implantation in a pseudophakic silicone oil-filled eye. A 44-year-old woman with Behcet's disease and congenital cataract underwent pars plana vitrectomy and silicone oil injection for pseudophakic rhegmatogenous retinal detachment. Despite maximum tolerated anti-glaucoma medications, uncontrolled intraocular pressure (IOP) prompted Ahmed glaucoma drainage device implantation. Early postoperative findings revealed diffuse shall owing of the anterior chamber, peripheral iridocorneal touch, and an elevated, diffusely spread bleb with corneal contact. Diagnosis of over-filtration was established after excluding posterior segment pathologies. Initial interventions included anterior chamber reformation with cohesive viscoelastic and subsequent interventions due to recurrent shallowing. Silicone oil removal and localized zonulectomy during a follow-up visit successfully restored and maintained the anterior chamber for five months. This case underscores the efficacy of tailored surgical approaches in managing recurrent malignant glaucoma in complex scenarios.