摘要:
Objective: To discuss the relationship between ciliochoroidal detachment and malignant glaucoma with normal or higher intraocular pressure (IOP) after glaucoma surgery. Methods: 8 eyes (8 cases) with ciliochoroidal detachment and malignant glaucoma after glaucoma surgery were reviewed retrospectively. All 8 eyes were angle-closure glaucoma. After IOP was controlled to normal with topical pilicarpin, timolol and oral acetazolamide, 8 eyes received trabeculectomy under topical anesthemia and were treated with antibiotics, corticosteriods and eycloplegics. Results: 8 eyes showed flat anterior chamber, high IOP (mean 29.5 mmHg, range 24 ~ 50 mmHg), iridocorneal apposition at one month after trabeculectomy. Of 8 eyes, 7 were treated with drainage of surachoroidal fluid and gas injection into anterior chamber, 1 was treated with extracapsular cataract extraction, intraocular lens implantation, drainage of surachoroidal fluid and gas injection into anterior chamber. Surachoroidal fluid was seen during sleostomy in 8 eyes. After the second surgery, 8 eyes were treated with topical antibiotics corticosteriods, eyoloplegics, anterior chamber was deeper, and IOP was normal again. Conclusion: Ciliochoroidal detachment may be a step of the development of malignant glaucoma, or both of them may be the same disease with variations of clinical appearances; Malignant glaucoma should be considered in different diagnosis of a flat or shallow anterior chamber with normal or higher IOP after glaucoma surgery. Drainage of surachoroidal fluid is effective.