Link of Video Abstract: https://youtu.be/eGhTbOkaaQI
Introduction: Nanophthalmos basically is a simple microphthalmos with clinical characteristics of short axial length (AL), shallow anterior chamber (AC), high lens to eye volume ratio, small cornea and thick sclera, associated with angle closure glaucoma. We report a case of nanophthalmos with angle closure glaucoma and cataract who underwent trabeculectomy and end up with malignant glaucoma. Pars plana vitrectomy (PPV) and phacoemulsification with posterior chamber intraocular lens (PC IOL) implantation was done to manage the case.
Case Description: A 41-year-old man came with blurred vision in the right eye with redness and headache for 8 weeks. Intraocular pressure (IOP) was 46 mmHg, visual acuity was counting fingers at 2 m with nystagmus. Slit lamp examination revealed short axial length (AL), shallow anterior chamber (AC), small corneal diameter and high lens to eye volume. Trabeculectomy with 5FU was done with complication of malignant glaucoma. After PPV combined with phacoemulsification and PC IOL implantation, IOP was 14 mmHg, visual acuity 0.125 with deep AC.
Conclusion: Surgical intervention in nanophthalmos with angle closure glaucoma must be managed with good preparation. Malignant glaucoma in this case can be managed with pars plana vitrectomy and phacoemulsification without scleral procedure.