Competing/conflicts of interest: No stated conflict of interest.
Is preoperative ciliary body and iris anatomical configuration a predictor of malignant glaucoma development?
Article first published online: 24 JAN 2013
© 2012 The Authors. Clinical and Experimental Ophthalmology © 2012 Royal Australian and New Zealand College of Ophthalmologists
Clinical & Experimental Ophthalmology
Volume 41, Issue 6, pages 541–545, August 2013
How to Cite
Prata, T. S., Dorairaj, S., De Moraes, C. G., Mehta, S., Sbeity, Z., Tello, C., Liebmann, J. and Ritch, R. (2013), Is preoperative ciliary body and iris anatomical configuration a predictor of malignant glaucoma development?. Clinical & Experimental Ophthalmology, 41: 541–545. doi: 10.1111/ceo.12057
Funding sources: Supported by the Cardozo Foundation and the New York Glaucoma Research Institute, New York, NY.
- Issue published online: 31 JUL 2013
- Article first published online: 24 JAN 2013
- Accepted manuscript online: 25 DEC 2012 06:14AM EST
- Manuscript Accepted: 30 NOV 2012
- Manuscript Received: 1 AUG 2012
- Cardozo Foundation
- New York Glaucoma Research Institute, New York, NY
- malignant glaucoma;
- plateau iris configuration;
- ultrasound biomicroscopy
To investigate anatomical configuration of ciliary body and iris using ultrasound biomicroscopy as a predictor of malignant glaucoma development.
Retrospective study in a tertiary care hospital.
Cohort of 31 consecutive patients diagnosed with post-surgical malignant glaucoma.
Anterior chamber angle, iris and ciliary body configuration of involved eyes that had ultrasound biomicroscopy evaluation prior to the malignant glaucoma onset were evaluated. In cases with no presurgical ultrasound biomicroscopy exam of the involved eye, images from the fellow eye (imaged within 6 months) were analysed.
Main Outcome Measures
Thirty-one eyes (31 patients) had confirmed malignant glaucoma between 1996 and 2008. Most patients were women (65%) and had an anatomical narrow angle or angle-closure glaucoma (77%). Mean intraocular pressure at diagnosis was 30.4 ± 13.5 mmHg. The most common operation was trabeculectomy with mitomycin C (55%, 17/31 eyes), combined (3/17) or not (14/17) with cataract extraction and intraocular lens implantation. Among these 31 cases, we were able to evaluate the ultrasound biomicroscopy images of 13 patients (13 eyes) including involved eyes imaged prior to the malignant glaucoma onset or eligible fellow eyes. A narrow angle with or without iridotrabecular contact was found in all eyes. A large and/or anteriorly positioned ciliary body associated with an iris root angulating forward and centrally, revealing a plateau iris configuration, was noticed in 85% (11/13) of these eyes.
Identification of plateau iris configuration by ultrasound biomicroscopy should be considered as a possible predictor of post-operative malignant glaucoma development.