Abstract

SO.14.06

Reversal of primary angle-closure glaucoma by pars plana aspiration of aqueous humor

Walter Noske

Augenklinik, Städtisches Klinikum Brandenburg 

Primary Angle-Closure Glaucoma may not always be reversible by medical treatment and anterior segment surgery may be associated with further complications if intraocular pressure is very high.
We have aspirated 0,3 to 0,7 ml of aqueous humor with a fine canula (27G) in the pars plana region in 6 eyes with angele closure glaucoma that were unresponsive to medical treatment.
In all cases intraocular pressure was immediately reduced dramatically and the anterior chamber deepened. After aspiration fibrin and blood were seen on the iris, most likely as the consequence of the acute pressure reduction, that resorbed spontaneously. After reduction of the intraocular pressure in all eyes the primary angle-closure glaucoma was corrected surgically. In 5 of 6 cases intraocular pressure was normalized, in one case intraocular pressure was 24 mm Hg three months after the angle-closure attack.
Pars plana aspiration of aqueous humor may be a useful option to relieve acute angle-closure glaucoma if intraocular pressure cannot be reduced sufficiently and surgical measures are problematic because of the increased intraocular pressure.

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