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  • Glaucoma

    This retrospective study identified plateau iris configuration as a common characteristic of eyes that later developed post-surgical malignant glaucoma. It also confirmed some previously described demographic and clinical features associated with malignant glaucoma.

    To the best of the authors’ knowledge, this is the largest reported series of patients with malignant glaucoma confirmed both clinically and by imaging, and the first to identify an associated pattern of ciliary body and iris configuration in a large series of patients.

    The authors reviewed the charts of 31 consecutive patients diagnosed with post-surgical malignant glaucoma at a tertiary care hospital in Utah.

    Consistent with previously reported demographic data, most of the patients (65 percent) were women and were of older age (mean 69.7 years). Most were also slightly hyperopic and had an anatomical narrow angle or angle-closure glaucoma (77 percent). The authors were able to evaluate the ultrasound biomicroscopy images of 13 of the 31 patients.

    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 percent of eyes.

    They conclude that early identification of plateau iris configuration using ultrasound biomicroscopy should be considered as a possible predictor of postoperative malignant glaucoma development.