Abstract

Aim: To assess the value of slit lamp adapted optical coherence tomography (OCT) for the management of malignant glaucoma following filtration surgery.

Methods: Two patients (three eyes) developed malignant glaucoma following filtration surgery for primary open angle glaucoma (POAG). With slit lamp adapted OCT it was possible to image non-invasively the anterior chamber angle structures during the malignant glaucoma episode, and after pars plana vitrectomy (PPV) with anterior chamber reformation.

Results: OCT revealed in both patients a markedly decreased anterior chamber angle with extreme shallowing of the anterior chamber depth during the acute malignant glaucoma phase. This critical closure of the anterior chamber angle resolved after PPV and deepening of the anterior chamber with viscoelastic. After PPV the quantitative values of the anterior chamber angle (ACA) and the anterior chamber opening distance (AOD) increased from 0 to an ACA of 35° (SD 14°) and an AOD of 426 (SD 162) μm.

Conclusions: Non-contact slit lamp adapted OCT was helpful to evaluate the anterior chamber structures in malignant glaucoma, and thus could improve management of this serious clinical disorder.