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Published in: Ophthalmology and Therapy 1/2024

Open Access 20-11-2023 | Iridectomy | ORIGINAL RESEARCH

Management of Pseudophakic Malignant Glaucoma Using Modified Nd:YAG Laser Treatment Methodology Through Surgical Preset Iridectomy

Authors: Mingmin Yang, Xiaohua Pan, Zijie Chen, Xiaoli Shen, Zhen Yu, Yufei Tao, Shan Li, Xiang Mo, Xuyang Liu, Ning Fan

Published in: Ophthalmology and Therapy | Issue 1/2024

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Abstract

Introduction

The use of the neodymium:yttrium–aluminum-garnet (Nd:YAG) laser to treat malignant glaucoma (MG) has been described in the literature since the 1980s. However, the technique has been reported to have a short-term effect, with a notable relapse rate. In the present study, we report the efficacy and durability of a modified Nd:YAG laser treatment methodology for treatment of pseudophakic or aphakic MG.

Methods

Patients with chronic angle-closure glaucoma and deemed at high risk of developing post-operative MG received prophylactic peripheral iridectomy during their conventional operation beginning in 2017. When the diagnosis of pseudophakic or aphakic MG was confirmed, a thorough Nd:YAG laser capsulo/zonulo-hyaloido-vitreolysis (CZHV) was performed through iridectomy, along with standardized pre- and post-laser medications. This retrospective case series includes 14 eyes of 11 patients with MG who had surgical preset iridectomy and modified Nd:YAG laser CZHV between 2017 and 2022. Outcome measures included resolution and recurrence of MG and incidence of treatment complications.

Results

The mean follow-up was 27.1 ± 15.0 months (range, 12–48). Long-term resolution of MG was obtained in all included eyes at the end of the follow-up. Six eyes (42.9%) achieved long-term resolution with a single Nd:YAG laser intervention. Eight eyes (57.1%) achieved long-term resolution following two to three laser interventions, with two eyes (14.3%) experiencing recurrence. There was no complication during the follow-up. At the final visit, a significant reduction (P = 0.0001) in the mean intraocular pressure (IOP) was observed (13.1 ± 2.8 mmHg) compared to presentation (21.4 ± 6.3 mmHg).

Conclusion

The modified Nd:YAG laser treatment methodology is a minimally invasive option to manage pseudophakic or aphakic MG with sustained effectiveness. Reduced inflammatory reactions due to prophylactic peripheral iridectomy, rapid diagnosis, and timely treatment initiation have all contributed to the favorable outcomes associated with this modified treatment methodology.
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Metadata
Title
Management of Pseudophakic Malignant Glaucoma Using Modified Nd:YAG Laser Treatment Methodology Through Surgical Preset Iridectomy
Authors
Mingmin Yang
Xiaohua Pan
Zijie Chen
Xiaoli Shen
Zhen Yu
Yufei Tao
Shan Li
Xiang Mo
Xuyang Liu
Ning Fan
Publication date
20-11-2023
Publisher
Springer Healthcare
Published in
Ophthalmology and Therapy / Issue 1/2024
Print ISSN: 2193-8245
Electronic ISSN: 2193-6528
DOI
https://doi.org/10.1007/s40123-023-00851-5

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