{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,13]],"date-time":"2026-07-13T21:15:42Z","timestamp":1783977342725,"version":"3.55.0"},"reference-count":27,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2026,3,27]],"date-time":"2026-03-27T00:00:00Z","timestamp":1774569600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Reports"],"abstract":"<jats:p>Background and Clinical Significance: Malignant glaucoma, also described as aqueous misdirection syndrome, most commonly occurs following trabeculectomy in patients with primary angle-closure glaucoma and a shallow anterior chamber. Management aims to restore normal anterior segment anatomy, re-establish aqueous flow from the posterior to the anterior chamber, and achieve adequate intraocular pressure control. This report presents a case of malignant glaucoma developing after trabeculectomy, with emphasis on current diagnostic and therapeutic approaches. Case Presentation: A patient with primary angle-closure glaucoma, pseudophakia of the right eye, and a patent laser peripheral iridotomy, receiving maximal tolerated topical antiglaucoma therapy, was referred to the Department of Ophthalmology due to uncontrolled intraocular pressure. The patient was scheduled for trabeculectomy of the right eye. In the immediate postoperative period, intraocular pressure was adequately controlled. However, on postoperative day five, a significant elevation in intraocular pressure was observed, accompanied by persistent shallowing of the anterior chamber. Topical and systemic hypotensive therapy, posterior capsulotomy and hyaloidotomy were performed without improvement of the local condition. The patient was qualified for irido-zonulectomy with pars plana vitrectomy. Following surgical intervention, normalization of intraocular pressure was achieved, and the anatomy of the anterior chamber was restored. Conclusions: Malignant glaucoma remains a challenging postoperative complication and is frequently refractory to conservative pharmacological and laser-based interventions. Early recognition and prompt surgical management, particularly irido-zonulectomy combined with pars plana vitrectomy, significantly increase the likelihood of anatomical and functional success.<\/jats:p>","DOI":"10.3390\/reports9020102","type":"journal-article","created":{"date-parts":[[2026,3,27]],"date-time":"2026-03-27T11:12:25Z","timestamp":1774609945000},"page":"102","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Malignant Glaucoma After Trabeculectomy\u2014Diagnosis and Treatment Options: A Case Report"],"prefix":"10.3390","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0819-8512","authenticated-orcid":false,"given":"Ada","family":"Sterczewska","sequence":"first","affiliation":[{"name":"Department of Ophthalmology, Prof. K. Gibinski University Clinical Centre, Medical University of Silesia in Katowice, 40-514 Katowice, Poland"},{"name":"Department of Ophthalmology, Faculty of Medical Sciences in Katowice, Medical University of Silesia in Katowice, 40-514  Katowice, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adrian","family":"Sm\u0119dowski","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Prof. K. Gibinski University Clinical Centre, Medical University of Silesia in Katowice, 40-514 Katowice, Poland"},{"name":"Department of Ophthalmology, Faculty of Medical Sciences in Katowice, Medical University of Silesia in Katowice, 40-514  Katowice, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Justyna","family":"Sierocka-St\u0119pie\u0144","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Prof. K. Gibinski University Clinical Centre, Medical University of Silesia in Katowice, 40-514 Katowice, Poland"},{"name":"Department of Ophthalmology, Faculty of Medical Sciences in Katowice, Medical University of Silesia in Katowice, 40-514  Katowice, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5336-3460","authenticated-orcid":false,"given":"Dorota","family":"Wygl\u0119dowska-Promie\u0144ska","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Prof. K. Gibinski University Clinical Centre, Medical University of Silesia in Katowice, 40-514 Katowice, Poland"},{"name":"Department of Ophthalmology, Faculty of Medical Sciences in Katowice, Medical University of Silesia in Katowice, 40-514  Katowice, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mariola","family":"Dorecka","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Prof. K. Gibinski University Clinical Centre, Medical University of Silesia in Katowice, 40-514 Katowice, Poland"},{"name":"Department of Ophthalmology, Faculty of Medical Sciences in Katowice, Medical University of Silesia in Katowice, 40-514  Katowice, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,3,27]]},"reference":[{"key":"ref_1","first-page":"108","article-title":"Beitrage zur pathologie und therapie des glaucoms","volume":"15","year":"1869","journal-title":"Arch. Ophtalmol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"160","DOI":"10.24292\/01.OT.300919.02","article-title":"Jaskra z\u0142o\u015bliwa: Nowe pogl\u0105dy na etiopatogenez\u0119 i post\u0119powanie","volume":"6","year":"2019","journal-title":"OphthaTherapy"},{"key":"ref_3","first-page":"9616738","article-title":"Risk Factors of Malignant Glaucoma Occurrence after Glaucoma Surgery","volume":"2017","year":"2017","journal-title":"J. Ophthalmol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"993","DOI":"10.1016\/0002-9394(51)91168-3","article-title":"Malignant glaucoma","volume":"34","author":"Chandler","year":"1951","journal-title":"Am. J. Ophthalmol."},{"key":"ref_5","first-page":"63","article-title":"Management strategies in malignant glaucoma secondary to antiglaucoma surgery","volume":"9","author":"Wu","year":"2016","journal-title":"Int. J. Ophthalmol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"572","DOI":"10.1016\/j.mehy.2004.07.035","article-title":"Lesser anterior chamber dimensions in women may be a predisposing factor for malignant glaucoma","volume":"64","author":"Razeghinejad","year":"2005","journal-title":"Med. Hypotheses"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"389","DOI":"10.4103\/joco.joco_147_22","article-title":"Management of Malignant Glaucoma","volume":"34","author":"Sadeghi","year":"2023","journal-title":"J. Curr. Ophthalmol."},{"key":"ref_8","first-page":"217","article-title":"The role of vitreous detachment in aphakic and malignant glaucoma","volume":"58","author":"Shaffer","year":"1954","journal-title":"Trans. Am. Acad. Ophthalmol. Otolaryngol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"167","DOI":"10.1097\/00061198-200304000-00013","article-title":"Possible mechanisms of primary angle-closure and malignant glaucoma","volume":"12","author":"Quigley","year":"2003","journal-title":"J. Glaucoma"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"1078","DOI":"10.1016\/0002-9394(79)90420-3","article-title":"Experimental perfusions through the anterior and vitreous chambers with possible relationships to malignant glaucoma","volume":"88","author":"Epstein","year":"1979","journal-title":"Am. J. Ophthalmol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"952","DOI":"10.1136\/bjo.87.8.952","article-title":"Optical coherence tomography in malignant glaucoma following filtration surgery","volume":"87","author":"Wirbelauer","year":"2003","journal-title":"Br. J. Ophthalmol."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"852659","DOI":"10.1155\/2012\/852659","article-title":"Malignant glaucoma: A review of the modern literature","volume":"2012","author":"Shahid","year":"2012","journal-title":"J. Ophthalmol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"1155","DOI":"10.1007\/s00347-022-01718-z","article-title":"Therapie des malignen Glaukoms","volume":"119","author":"Unterlauft","year":"2022","journal-title":"Ophthalmologie"},{"key":"ref_14","first-page":"283707","article-title":"Clinical Management of Malignant Glaucoma","volume":"2015","author":"Netland","year":"2015","journal-title":"J. Ophthalmol."},{"key":"ref_15","unstructured":"Dorairaj, S., Chan, I., and Teng, C.C. (2010). Diagnosis and Management of Malignant Glaucoma. EyeNet Mag."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"e44","DOI":"10.1097\/IJG.0000000000001145","article-title":"Malignant Glaucoma After Laser Peripheral Iridotomy","volume":"28","author":"Greenfield","year":"2019","journal-title":"J. Glaucoma"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"1415","DOI":"10.1038\/s41598-024-83659-y","article-title":"Treatment of pseudophakic aqueous misdirection syndrome","volume":"15","author":"Lincke","year":"2025","journal-title":"Sci. Rep."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"499","DOI":"10.1136\/bjo.78.6.499","article-title":"Treatment of aphakic malignant glaucoma using Nd:YAG laser posterior capsulotomy","volume":"78","author":"Little","year":"1994","journal-title":"Br. J. Ophthalmol."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"131","DOI":"10.1007\/s00417-011-1763-0","article-title":"Outcomes of different management options for malignant glaucoma: A retrospective study","volume":"250","author":"Debrouwere","year":"2012","journal-title":"Graefe\u2019s Arch. Clin. Exp. Ophthalmol."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"1094","DOI":"10.1038\/eye.2016.106","article-title":"Clinical efficacy of modified partial pars plana vitrectomy combined with phacoemulsification for malignant glaucoma","volume":"30","author":"He","year":"2016","journal-title":"Eye"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"282","DOI":"10.1016\/j.ogla.2023.12.005","article-title":"Long-term Treatment Outcomes for Malignant Glaucoma","volume":"7","author":"Jin","year":"2024","journal-title":"Ophthalmol. Glaucoma"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"135","DOI":"10.1007\/s00417-017-3837-0","article-title":"Acute and chronic fluid misdirection syndrome: Pathophysiology and treatment","volume":"256","author":"Grzybowski","year":"2018","journal-title":"Graefe\u2019s Arch. Clin. Exp. Ophthalmol."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"761","DOI":"10.1038\/eye.2014.53","article-title":"Efficacy and safety of a new surgical method to treat malignant glaucoma in pseudophakia","volume":"28","author":"Kalinowska","year":"2014","journal-title":"Eye"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"1968","DOI":"10.1016\/j.ophtha.2006.04.031","article-title":"Vitrectomy-phacoemulsification-vitrectomy for the management of aqueous misdirection syndromes in phakic eyes","volume":"113","author":"Sharma","year":"2006","journal-title":"Ophthalmology"},{"key":"ref_25","first-page":"873124","article-title":"Evaluation of the Effectiveness of Surgical Treatment of Malignant Glaucoma in Pseudophakic Eyes through Partial PPV with Establishment of Communication between the Anterior Chamber and the Vitreous Cavity","volume":"2015","year":"2015","journal-title":"J. Ophthalmol."},{"key":"ref_26","first-page":"794938","article-title":"Surgical Management of Pseudophakic Malignant Glaucoma via Anterior Segment-Peripheral Iridectomy Capsulo-Hyaloidectomy and Anterior Vitrectomy","volume":"2012","author":"Pasaoglu","year":"2012","journal-title":"Case Rep. Ophthalmol. Med."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"387","DOI":"10.1016\/S0002-9394(99)00405-5","article-title":"Pars plana vitrectomy during cataract surgery for prevention of aqueous misdirection in high-risk fellow eyes","volume":"129","author":"Flynn","year":"2000","journal-title":"Am. J. Ophthalmol."}],"container-title":["Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2571-841X\/9\/2\/102\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,27]],"date-time":"2026-03-27T11:35:18Z","timestamp":1774611318000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2571-841X\/9\/2\/102"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3,27]]},"references-count":27,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2026,6]]}},"alternative-id":["reports9020102"],"URL":"https:\/\/doi.org\/10.3390\/reports9020102","relation":{},"ISSN":["2571-841X"],"issn-type":[{"value":"2571-841X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,3,27]]}}}