Malignant Glaucoma after Laser Peripheral Iridotomy

Purpose: We describe a patient with primary angle-closure glaucoma who developed malignant glaucoma following laser peripheral iridotomy. Methods: A 58-year-old male presented with peripheral and central anterior chamber shallowing following an uncomplicated Nd: YAG laser peripheral iridotomy. Intraocular pressure and B-scan echography were normal, and there was -1.5 diopter asymmetric myopia. Despite treatment with aqueous suppression and cycloplegia for 7 months, the patient developed progressive myopic shift and anterior chamber shallowing. Results: The patient underwent 23-gauge pars plana vitrectomy and lensectomy using a standard 3-port technique, and sulcus posterior chamber intraocular lens implantation in the left eye. Twelve months postoperatively, the anterior chamber has remained deep, best-corrected visual acuity is 20/15, and the IOP is 11mmHg. Conclusions: Malignant glaucoma is a rare complication of laser iridotomy and should be considered in eyes with progressive anterior chamber shallowing and myopia despite normal intraocular pressure.