Causes of failures in the treatment of malignant glaucoma after cataract removal based on an analysis of several case studies

The study analyses the causes of ineffective malignant glaucoma treatment applied in 4 patients (6 eyes). Glaucoma symptoms appeared immediately after cataract removal. The common feature of the applied therapies was the desire to lower eye pressure using various methods. The most important element of treatment, i.e. restoring the correct anatomical relations in the eye, was left out during treatment. The prolonged time in the implementation of effective therapy results in progressive visual impairment and appearance of irreversible lesions in the anterior segment of the eye. In addition, it puts the patient at risk of experiencing constant eye pain, even if the intraocular pressure is normalized. The key to therapeutic success is restoration of the physiological distribution of the aqueous humour. Nonsurgical methods of treating malignant glaucoma, if ineffective, should be replaced by surgery within several days. The procedure of choice is excision of the vitreous from the area of the lens and the ciliary body with its anterior capsule, performed from the posterior approach. This method seems to be the most effective in pseudophakic eyes, and the time of its implementation has a decisive impact on obtaining a beneficial effect of the procedure and reducing the risk of postoperative complications.