Surgery Delivers Superior Results in Malignant Glaucoma

Elderly female patient having an eye checkup
Close up portrait of a smiling serene blonde aged Caucasian woman undergoing a slit lamp examination
A presentation at the AAO demonstrated the utility of big data to understand real-world care of rare ophthalmic conditions.

This article is part of Ophthalmology Advisor’s conference coverage from the 2021 meeting of the American Academy of Ophthalmology, held in New Orleans from November 12 to 15, 2021. The team at Ophthalmology Advisor will be reporting on a variety of the research presented by the ophthalmology experts at the AAO. Check back for more from the AAO 2021 Meeting.


Malignant glaucoma patients managed surgically have visual outcomes superior to those not managed surgically, according to research presented at the American Academy of Ophthalmology 2021 annual conference. The investigators used the Intelligent Research in Sight (IRIS) registry to identify 4099 patients using 2 ICD 9/10 codes (365.83, H40.83) who sought treatment between January 1, 2013 and December 31, 2018 (mean age being 65.7±13.3 years, 58.2% women). The data showed that 6.8% of patients (Group 1) received either laser hyaloidotomy or transscleral cyclophotocoagulation within 1 year of diagnosis index date,(Group 1). Another 18% (Group 2) received surgical management. The remainder of patients (Group 3) were classified as receiving medical management. 

Patients in Groups 1 and 3 did not show improvement of visual acuity (P =.058 and P =.075, respectively). Those in Group 2 showed significant improvement in mean logMAR visual acuity (VA) from baseline at 1 year postindex date (0.14 units; P =.001). 

The overall outcome of this study demonstrated how useful big data is to better understand patient outcomes and real-world care for patients with rare conditions such as malignant glaucoma and those treated surgically may have better visual outcomes than other treatment options, according to the presenters.

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Cote S, Elze T, Lorch AC, et al. Treatment patterns for malignant glaucoma in the United States: analysis of the IRIS registry. Paper presented at: The American Academy of Ophthalmology 2021 Annual Meeting; November 12-15, 2021; New Orleans. Abstract PA003.