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Jeffrey M. Liebmann, MD; Robert N. Weinreb, MD; Robert Ritch, MD

Arch Ophthalmol. 1998;116:731-735.

Objective  To evaluate the role of annular ciliary body detachment in the development of postoperative angle-closure glaucoma.

Design  Case series.

Setting  Tertiary care glaucoma referral center.

Methods  High-resolution, anterior segment ultrasound biomicroscopy, ophthalmoscopy, and B-scan ultrasonography were performed on 6 eyes of 6 patients with a clinical diagnosis of postoperative malignant glaucoma.

Results  Each eye had an elevated intraocular pressure, a shallow anterior chamber, 1 or more patent iridectomies, and no ophthalmoscopic or B-scan ultrasound evidence of serous or hemorrhagic ciliochoroidal detachment. Ultrasound biomicroscopy revealed annular ciliary body detachment in each eye. In 4 eyes, observation with topical medical treatment was associated with deepening of the anterior chamber, reduced intraocular pressure, and resolution of the detachment. Drainage of the supraciliary fluid was performed in 2 eyes.

Conclusion  Occult, annular, serous detachment of the ciliary body may cause postoperative angle-closure glaucoma. This entity is clinically indistinguishable from malignant glaucoma. Ultrasound biomicroscopy facilitates the diagnosis.

From the Departments of Ophthalmology, The New York Eye and Ear Infirmary, New York City and New York Medical College, Valhalla, NY (Drs Liebmann and Ritch); and the University of California at San Diego, La Jolla, Calif (Dr Weinreb).

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