{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T15:10:16Z","timestamp":1785424216140,"version":"3.56.0"},"reference-count":27,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2026,5,28]],"date-time":"2026-05-28T00:00:00Z","timestamp":1779926400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"University of Medicine and Pharmacy Carol Davila"},{"id":[{"id":"https:\/\/ror.org\/04fm87419","id-type":"ROR","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Life"],"abstract":"<jats:p>Background: Primary angle-closure glaucoma (PACG) carries a high risk of irreversible blindness. This case highlights the challenges of managing refractory PACG in a patient with a history of prematurity and the subsequent development of postoperative complications. Case Presentation: A 45-year-old woman with a history of prematurity and monocular vision (no light perception in left eye) presented with acute angle closure in the right eye (RE). Despite maximal medical therapy, the RE intraocular pressure (IOP) remained at 54 mmHg. Less invasive options like laser iridotomy or standalone lens extraction were deemed insufficient, and to achieve efficient IOP lowering, the patient underwent combined phacotrabeculectomy, which was soon complicated by malignant glaucoma (aqueous misdirection) and hyphema. This necessitated a secondary intervention involving pars plana anterior vitrectomy and posterior capsulotomy. Over an 18-month follow-up, the patient suffered recurrent complications, including a spontaneous vitreous hemorrhage and eventually uncontrolled IOP. Management required a vitrectomy and the subsequent implantation of an Ahmed glaucoma valve. Although the valve procedure was followed by a transient early postoperative hyphema, the patient\u2019s condition stabilized. At the final 28-month follow-up, the RE best corrected visual acuity was 20\/25 with an IOP of 12\u201318 mmHg without medication. Conclusions: This case notes an interesting coexistence of advanced adult-onset angle-closure glaucoma and a history of prematurity, though a direct causal or anatomical link remains speculative due to the lack of advanced anterior segment imaging. The clinical course underscores the necessity of aggressive surgical management for aqueous misdirection and the risk of recurrent intraocular hemorrhage in advanced glaucoma. While a definitive developmental relationship cannot be established from a single case, this presentation highlights that an individualized history of prematurity may be a noteworthy consideration during comprehensive long-term ophthalmic evaluations.<\/jats:p>","DOI":"10.3390\/life16060907","type":"journal-article","created":{"date-parts":[[2026,5,28]],"date-time":"2026-05-28T12:09:07Z","timestamp":1779970147000},"page":"907","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Sequential Surgical Management of Refractory Primary Angle-Closure Glaucoma in a Functionally Monocular Patient"],"prefix":"10.3390","volume":"16","author":[{"given":"Valeria","family":"Coviltir","sequence":"first","affiliation":[{"name":"Ophthalmology Discipline, Carol Davila University of Medicine and Pharmacy, 8 Eroii Sanitari Blvd, 050474 Bucharest, Romania"},{"name":"Department of Ophthalmology, Clinical Institute of Ophthalmological Emergencies \u201cProf. Dr. Mircea Olteanu\u201d, 010464 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8242-8809","authenticated-orcid":false,"given":"Maria Cristina","family":"Marinescu","sequence":"additional","affiliation":[{"name":"Medical Physiology Discipline, Carol Davila University of Medicine and Pharmacy, 8 Eroii Sanitari Blvd, 050474 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miruna Gabriela","family":"Burcel","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Transilvania University of Brasov, 56 Nicolae B\u0103lcescu Street, 500019 Brasov, Romania"},{"name":"Brasov County Emergency Clinical Hospital, 25 Bucure\u0219ti Avenue, 500326 Brasov, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9579-3549","authenticated-orcid":false,"given":"Cosmin Adrian","family":"Teodoru","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, \u201cLucian Blaga\u201d University of Sibiu, 550024 Sibiu, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2395-3683","authenticated-orcid":false,"given":"Maria-Emilia","family":"Cerghedean-Florea","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, \u201cLucian Blaga\u201d University of Sibiu, 550024 Sibiu, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,5,28]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Nicola, C.A., Marinescu, M.C., Firan, A.M., Tartea, G., Naidin, M.S., Ciuluvica, R.C., Dimulescu, M.D., Voicu, N.M., Mihailescu, C.M., and Meca, A.-D. 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