Treatment of Malignant Glaucoma with Intravenous Mannitol Infusion

Abstract
Malignant glaucoma, appropriately so named by von Graefe in 1869,1is a dire elevation of intraocular pressure occurring hours, days, or weeks after glaucoma surgery in the shallow-chambered eye with an elevated intraocular pressure,2and characterized by absence or extreme shallowing of the anterior chamber and a refractoriness to the usual methods of glaucoma therapy. It is an uncommon complication in which there is a forward movement of the lens-iris diaphragm, probably related to sudden loss of anterior chamber aqueous during or soon after surgery. The posteroanterior flow of aqueous humor is blocked, the aqueous being trapped behind a relatively large lens or pooling within the vitreous or behind a detached vitreous body.3 Until recently the medical treatment of malignant glaucoma has been useless, even worsening the prognosis by unduly delaying the necessary surgical measures. Posterior sclerotomy and re-formation of the anterior chamber with air or saline