Abstract

Aim – To describe management approach to a case of malignant glaucoma unresolved despite Pars Plana Vitrectomy
Methods – A 73 year old patient who had undergone uncomplicated cataract surgery developed malignant glaucoma an year later .He was managed using stepladder approach of medical therapy, laser , PPV sequentially , however, he did not respond& the IOP remained intractably high . Eventually the condition resolved after YAG hyaloidotomy done through the surgical PI .
Results- After the procedure , AC deepened , IOP got controlled & vision restored.
Conclusion – PPV + IZHV(irido-zonulo-hyaloido-vitrectomy)is the treatment for malignant glaucoma once medical & laser therapy fails .In rare cases refractive to PPV, YAG PI ± YAG hyalodotomy±local zonulectomy is a reasonable & minimally invasive surgical procedure