Skip to main content
SpringerLink
Log in

Malignant Glaucoma (Posterior Aqueous Diversion Syndrome)

  • Chapter
  • First Online:
Book cover The Glaucoma Book

  • 2537 Accesses

Abstract

Von Graefe1 first used the term malignant glaucoma to describe a devastating and unusual form of glaucoma that occurred following ocular surgery. This sequelae was asso­ciated with increased intraocular pressure (IOP) and flattening or shallowing of the anterior chamber. The word malignant was used to characterize the uniformly grave visual prognosis, but because of its relationship to cancer, many have objected to its use, preferring the term misdirection of aqueous. The current definition has been expanded to include classic malignant glaucoma and nonphakic malignant glaucoma as well as disorders occurring in other clinical situations. Classic malignant glaucoma is usually associated with a specific clinical scenario that occurs after incisional surgery (iridectomy or filtration) for primary angle-closure glaucoma, secondary or chronic angle-closure glaucoma, or at times open-angle glaucoma in phakic patients (Table 37.1). The occurrence of malignant glaucoma after cataract surgery and the persistence of malignant glaucoma following cataract surgery in the classic form have been termed as aphakic malignant glaucoma. The diagnosis nonphakic malignant glaucoma has been suggested for both aphakic and pseudophakic types 2 and may also be applied to the development of malignant glaucoma after combined cataract and filtration surgery. The term malignant-like glaucoma has been proposed for instances with similar clinical presentations but where different underlying pathophysiology may be present.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 219.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Hardcover Book
USD 279.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. von Graefe A. Beitrage zur Palhologie und Therapie des Glaukoms. Arch Ophthalmol. 1869;15:108.

    Google Scholar 

  2. Levene R. Malignant glaucoma: Proposed definition and classification. In: Shields MB, Pollack I, Kolker A, eds. Perspectives in Glaucoma. Transactions of the First Scientific Meeting of the American Glaucoma Society. Thorofare, NJ: Slack; 1988:243–350.

    Google Scholar 

  3. Weiss DI, Shaffer RN. Ciliary block (malignant glaucoma). Trans Am Acad Ophthalmol Otol. 1972;76:450.

    CAS  Google Scholar 

  4. Shaffer RN, Hoskins HD Jr. Ciliary block (malignant glaucoma). Ophthalmology. 1978;85:215.

    CAS  PubMed  Google Scholar 

  5. Levene R. A new concept of malignant glaucoma. Arch Ophthalmol. 1972;87:497.

    CAS  PubMed  Google Scholar 

  6. Chandler PA, Simmons RJ, Grant WM. Malignant glaucoma: Medical and surgical treatment. Am J Ophthalmol. 1968;66:495.

    CAS  PubMed  Google Scholar 

  7. Simmons RJ. Malignant glaucoma. Br J Ophthalmol. 1972;56:263.

    Article  CAS  PubMed  Google Scholar 

  8. Simmons RJ, Thomas IV, Yaqub MK. Malignant glaucoma. In: Ritch R, Shields MB, Krupin T, eds. The Glaucomas. CV Mosby: St. Louis; 1989:1251–1263.

    Google Scholar 

  9. Simmons RJ. Malignant glaucoma. III In: Epstein DL, ed. Chandler and Grant’s Glaucoma. Philadelphia, PA: Lea & Febiger; 1986:264–278.

    Google Scholar 

  10. Trope GE, Pavlin CJ, Bau A, et al. Malignant glaucoma: Clinical and ultrasound biomicroscopic features. Ophthalmology. 1994;101:1030.

    CAS  PubMed  Google Scholar 

  11. Merritt JC. Malignant glaucoma induced by miotics postoperatively in open-angle glaucoma. Arch Ophthalmol. 1977;95:1988.

    CAS  PubMed  Google Scholar 

  12. Hoshiwara I. Case report of simultaneous malignant glaucoma occurring 3 years after glaucoma surgery. Arch Ophthalmol. 1964;72:601.

    CAS  PubMed  Google Scholar 

  13. Gorin G. Angle-closure glaucoma induced by miotics. Am J Ophthalmol. 1966;62:1063.

    CAS  PubMed  Google Scholar 

  14. Jafar MS, Tomey KF. Malignant glaucoma manifesting bilaterally 15 months after peripheral iridectomy. Glaucoma. 1982;4:177.

    Google Scholar 

  15. Ellis PP. Malignant glaucoma occurring 16 years after successful filtering surgery. Ann Ophthalmol. 1984;16:177.

    CAS  PubMed  Google Scholar 

  16. Wollensak I, Pham DT, Anders N. Ciliolenticular block as a late complication in pseudophakia. Ophthalmologe. 1995;92:280.

    CAS  PubMed  Google Scholar 

  17. Hanish SJ, Lamberg RL, Gordon JM. Malignant glaucoma following cataract extraction and intraocular lens implant. Ophthalmic Surg. 1982;13:713.

    CAS  PubMed  Google Scholar 

  18. Epstein DL. Pseudophakic malignant glaucoma-Is it really pseudomalignant? Am J Ophthalmol. 1987;103:231.

    CAS  PubMed  Google Scholar 

  19. Arya SK, Sonika S, Kochhar S. Malignant glaucoma as a complication of Nd:YAG laser posterior capsulotomy. Ophthalmic Surg Lasers Imaging. 2004;35:248–250.

    PubMed  Google Scholar 

  20. Azuara-Blanco A, Dua HS. Malignant glaucoma after diode laser cyclophotocoagulation. Am J Ophthalmol. 1999;127:467–469.

    Article  CAS  PubMed  Google Scholar 

  21. Greenfield DS, Tello C, Budenz DL, Liebman JM, Ritch R. Aqueous misdirection after glaucoma drainage device implantation. Ophthalmology. 1999;106:1035–1040.

    Article  CAS  PubMed  Google Scholar 

  22. Luntz MH, Rosenblatt M. Malignant glaucoma. Surv Ophthalmol. 1987;32:73.

    Article  CAS  PubMed  Google Scholar 

  23. Brooks AM, Halper CA, Gillies WE. Occurrence of malignant glaucoma after laser iridotomy. Br J Ophthalmol. 1989;73:617.

    Article  CAS  PubMed  Google Scholar 

  24. Robinson A, Plialnic M, Deutsch D, et al. The onset of malignant glaucoma after prophylactic laser iridotomy. Am J Ophthalmol. 1990;110:95.

    CAS  PubMed  Google Scholar 

  25. Aminlati A, Sassani JW. Simultaneous bilateral malignant glaucoma following laser iridotomy. Graefes Arch Clin Exp Opbthalmol. 1993;231:12.

    Article  Google Scholar 

  26. Di Sclafani M, Liebmann JM, Ritch R. Malignant glaucoma following argon laser release of scleral flap sutures after trabeculectomy. Am J Ophthalmol. 1989;108:597.

    Google Scholar 

  27. Macken P, Buys Y, Trope GE. Glaucoma laser suture lysis. Br J Ophthalmol. 1996;80:398.

    Article  CAS  PubMed  Google Scholar 

  28. Hardten DR, Brown JD. Malignant glaucoma after Nd:YAG cyclophotocoagulation. Am J Ophthalmol. 1991;111:245.

    CAS  PubMed  Google Scholar 

  29. Pecora JL. Malignant glaucoma worsened by miotics in a postoperative angle-closure glaucoma patient. Ann Ophthalmol. 1979;11:1412.

    CAS  PubMed  Google Scholar 

  30. Rieser JC, Schwartz B. Miotic-induced malignant glaucoma. Arch Ophthalmol. 1972;87:706.

    CAS  PubMed  Google Scholar 

  31. Pollard AF. Secondary angle closure glaucoma in cicatricial retrolental fibroplasia. Am J Ophthalmol. 1980;89:651.

    CAS  PubMed  Google Scholar 

  32. Kushner BJ. Ciliary block in retinopathy of prematurity. Arch Ophthalmol. 1982;100:1078.

    CAS  PubMed  Google Scholar 

  33. Lowe RF. Malignant glaucoma related to primary angle closure glaucoma. Aust N Z J Ophthalmol. 1979;7:11.

    Article  Google Scholar 

  34. Weiss IS, Deiter PO. Malignant glaucoma syndrome following retinal detachment surgery. Ann Ophthalmol. 1974;6:1099.

    CAS  PubMed  Google Scholar 

  35. Weber PA, Cohen JS, Baker O. Central retinal vein occlusion and malignant glaucoma. Arch Ophthalmol. 1987;105:635.

    CAS  PubMed  Google Scholar 

  36. Jones BR. Principles in the management of oculomycosis. Trans Am Acad Ophthalmol Otol. 1975;79:15.

    Google Scholar 

  37. Lass JH, Thoft RA, Bellows AR, et al. Exogenous Nocardia asteroides endophthalmitis associated with malignant glaucoma. Ann Ophthalmol. 1981;13:317.

    CAS  PubMed  Google Scholar 

  38. Schwartz AL, Anderson DR. “Malignant glaucoma” in an eye with no antecedent operation or miotics. Arch Ophthalmol. 1975;93:379.

    CAS  PubMed  Google Scholar 

  39. Chandler PA, Grant WM. Mydriatic-cycloplegic treatment in malignant glaucoma. Arch Ophthalmol. 1962;68:353.

    CAS  PubMed  Google Scholar 

  40. Epstein DL, Hashimoto JM, Anderson PJ, Grant WM. Experimental perfusions through the anterior and vitreous chambers with possible relationships to malignant glaucoma. Am J Ophthalmol. 1979;88:1078.

    CAS  PubMed  Google Scholar 

  41. Epstein DL. Malignant glaucoma. In: Jakobiec FA, Sigelman J, eds. Advanced Techniques in Ocular Surgery. WB Saunders: Philadelphia, PA; 1984:158–168.

    Google Scholar 

  42. Quigley HA. Malignant glaucoma and fluid flow rate. [Editorial]. Am J Ophthalmol. 1980;89:879.

    CAS  PubMed  Google Scholar 

  43. Epstein DL. Unifying concepts in malignant glaucoma. Glaucoma Under Pressure 1997 Symposium. American Academy of Ophthalmology Specialty Day. San Francisco, October 1997.

    Google Scholar 

  44. Epstein DL. The malignant glaucoma syndromes. In: Epstein DL, Allingham RR, Schuman JS, eds. Chandler and Grant’s Glaucoma. Media, PA: Williams & Wilkins; 1997:285–303.

    Google Scholar 

  45. Quigley HA, Friedman DS, Congdon NG. Possible mechanisms of primary angle-closure and malignant glaucoma. J Glaucoma. 2003;12:167–180.

    Article  PubMed  Google Scholar 

  46. Epstein DL, Steinert RF, Puliafito CA. Neodymium-YAG laser therapy to the anterior hyaloid in aphakic malignant (ciliovitreal block glaucoma). Am J Ophthalmol. 1984;98:137.

    CAS  PubMed  Google Scholar 

  47. Little BC, Hitchings RA. Pseudophakic malignant glaucoma: Nd:YAG capsulotomy as a primary treatment. Eye. 1993;7:102.

    PubMed  Google Scholar 

  48. Little BC. Treatment of aphakic malignant glaucoma using Nd:YAG laser posterior capsulotomy. Br J Ophthalmol. 1994;78:499.

    Article  CAS  PubMed  Google Scholar 

  49. Dugel PR, Heuer OK, Thach AB, et al. Annular peripheral choroidal detachment simulating aqueous misdirection after glaucoma surgery. Ophthalmology. 1997;104:439.

    CAS  PubMed  Google Scholar 

  50. Liebmann JM, Weinreb RN, Ritch R. Angle-closure glaucoma associated with occult annular ciliary body detachment. Arch Ophthalmol. 1998;16:731.

    Google Scholar 

  51. Rheindorf O. Uber Glaukom. Klin Monatsbl Augenheilkd. 1877; 25:148.

    Google Scholar 

  52. Weiss DI, Shaffer RN, Harrington DO. Treatment of malignant glaucoma with intravenous mannitol infusion: Medical reformation of the anterior chamber by means of an osmotic agent: A preliminary report. Arch Ophthalmol. 1963;69:154.

    CAS  PubMed  Google Scholar 

  53. Beckman H, Blau RP. Oral steroid therapy for ciliary (pseudomalignant glaucoma). Glaucoma. 1981;3:169.

    Google Scholar 

  54. Herschler J. Laser shrinkage of the ciliary processes: A treatment for malignant (ciliary block) glaucoma. Ophthalmology. 1980;87:1155.

    CAS  PubMed  Google Scholar 

  55. Weber PA, Henry MA, Kapetansky FM, et al. Argon laser treatment of the ciliary processes in aphakic glaucoma with flat anterior chamber. Am J Ophthalmol. 1984;97:82.

    CAS  PubMed  Google Scholar 

  56. Risco JM, Tomey KF, Perkins TW. Laser capsulotomy through intraocular lens positioning holes in anterior aqueous misdirection. Arch Ophthalmol. 1989;107:1569.

    CAS  PubMed  Google Scholar 

  57. Momeda S, Hayashi H, Oshima K. Anterior pars plana vitrectomy for phakic malignant glaucoma. Jpn J Ophthalmol. 1983;27:73.

    Google Scholar 

  58. Benedikt O. A new operative method for the treatment of malignant glaucoma. Klin Monatsbl Augenheilkd. 1977;170:665.

    CAS  PubMed  Google Scholar 

  59. Luntz MH, Harrison R, Schenker H. Management of secondary glaucoma. In: Luntz MH, Harrison R, Schencker HI, eds. Glaucoma Surgery. Baltimore: Williams & Wilkins; 1984:107–116.

    Google Scholar 

  60. Boke W, Teichmann KDS, Junge W. Experiences with ciliary block (“malignant”) glaucoma. Klin Monatsbl Augenheilkd. 1980;177:407.

    Article  CAS  PubMed  Google Scholar 

  61. Koerner FH. Anterior pars plana vitrectomy in ciliary and iris block glaucoma. Graefs Arch Clin Exp Ophthalmol. 1980;214:119.

    Article  CAS  Google Scholar 

  62. Weiss H, Shin DH, Kollarits CR. Vitrectomy for malignant (ciliary block) glaucomas. Int Ophthalmol Clin. 1981;21:113.

    Article  CAS  PubMed  Google Scholar 

  63. Lynch MG, Brown RH, Michels RG, et al. Surgical vitrectomy for pseudophakic malignant glaucoma. AM J Ophthalmol. 1986;102:148.

    Article  Google Scholar 

  64. Byrnes GA, Leen MM, Wong TP, et al. Vitrectomy for ciliary block (malignant) glaucoma. Ophthalmology. 1995;102:1308.

    CAS  PubMed  Google Scholar 

  65. Harbour JW, Rubsamen PE, Palmberg P. Pars plana vitrectomy in the management of phakic and pseudophakic malignant glaucoma. Arch Ophthalmol. 1996;114:1073.

    CAS  PubMed  Google Scholar 

  66. Tsai JC, Barton KA, Miller MH, et al. Surgical results in malignant glaucoma refractory to medical or laser therapy. Eye. 1997;11:677.

    PubMed  Google Scholar 

  67. Lois N, Wong D, Groenwald C. New surgical approach in the management of pseudophakic malignant glaucoma. Ophthalmology. 2001;108:780–783.

    Article  CAS  PubMed  Google Scholar 

  68. Shields MB. Glaucomas following ocular surgery. In: Shields MD, ed. Textbook of Glaucoma. Baltimore: Williams & Wilkins; 1998:345–3500.

    Google Scholar 

  69. Shaffer RN. The role of vitreous detachment in aphakic and malignant glaucoma. Trans Am Acad Ophthalmol Otolaryngol. 1954;58:217.

    CAS  PubMed  Google Scholar 

  70. Tello C, Chi T, Shepps G, et al. Ultrasound biomicroscopy in pseudophakic malignant glaucoma. Ophthalmology. 1993;100:410.

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Oakland University William Beaumont School of Medicine, Rochester, MI, USA

    Marshall N. Cyrlin MD

  2. Glaucoma Services, William Beaumont Eye Institute, Royal Oak, MI, USA

    Marshall N. Cyrlin MD

  3. Southfield, MI, USA

    Marshall N. Cyrlin MD

Authors
  1. Marshall N. Cyrlin MD
    View author publications

    You can also search for this author in PubMed Google Scholar

Editor information

Editors and Affiliations

  1. 2889 10th Avenue, N., Palm Springs, 33461, USA

    Paul N. Schacknow

  2. Casey Eye Institute, Dept. Ophthalmology, Oregon Health & Sciences University, SW. Terwilliger Blvd. 3375, Portland, 97201-4197, USA

    John R. Samples

Rights and permissions

Reprints and permissions

Copyright information

© 2010 Springer Science+Business Media, LLC

About this chapter

Cite this chapter

Cyrlin, M.N. (2010). Malignant Glaucoma (Posterior Aqueous Diversion Syndrome). In: Schacknow, P., Samples, J. (eds) The Glaucoma Book. Springer, New York, NY. https://doi.org/10.1007/978-0-387-76700-0_37

Download citation

  • DOI: https://doi.org/10.1007/978-0-387-76700-0_37

  • Published:

  • Publisher Name: Springer, New York, NY

  • Print ISBN: 978-0-387-76699-7

  • Online ISBN: 978-0-387-76700-0

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation