An exceptional presentation of malignant glaucoma: case report.

INTRODUCTION AND

IMPORTANCE

Angle closure in pseudophakic patients with posterior chamber implants is a rare but serious complication following cataract surgery, often stemming from malignant glaucoma or pseudophakic pupillary block. While typically observed shortly after surgery, rare instances have been documented months to years postoperatively. This condition is characterized by the anterior displacement of the lens-iris-diaphragm complex.

CASE PRESENTATION: Displacement with an intact ciliary-lenticular block. We report a case of an 83-year-old female with a history of cataract surgery a decade prior who presented with a painful red eye and decreased visual acuity. Examination revealed elevated intraocular pressure, corneal edema, and peripheral athalamia, along with intact ciliary-lenticular block. The swift initiation of medical and surgical interventions is crucial to avoid vision loss in such rare and challenging scenarios.

CLINICAL DISCUSSION: To the best of our knowledge, this is the first case been reported of Malignant glaucoma with an intact ciliary-lenticular block. The pathophysiology is still unknown. The management of this condition is challenging, with no consensus on its management. The initiation of anterior vitrectomy and iridozonulohyaloidotomy should be considered promptly in malignant glaucoma for better postoperative outcomes.

CONCLUSION

Our case presentation is exceptional, characterized by a rare dual feature: the occurrence of malignant glaucoma 15 years after cataract surgery, and the anterior displacement of the iris with intact ciliary-lenticular block.