Prodromal malignant glaucoma.

FAILURES in the surgical management of malignant glaucoma (von Graefe, 1869; Smith, 1891; Chandler, 1950; McDonald, 1954) call attention to the syndrome of prodromal malignant glaucoma in which success has been reported (Birge, 1956). Based on a new and possibly radical operation performed before the devastating complications which give rise to malignant glaucoma can occur (Birge, 1952, 1953, 1956; Hughes, 1955; Wenaas and Stertzbach, 1955), this new concept of an old problem offers some hope to the otherwise hopeless individual afflicted with malignant glaucoma. Von Graefe (1869) described malignant glaucoma as "a new and acute glaucomatous process brought about by surgery, which is unusual only in the continued failure of the anterior chamber to form". The increasing intra-ocular tension which followed this series of events was usually treated by surgical procedures on the lens, sometimes with less than desired success (Pagenstecher, 1877; Rheindorf, 1887; Smith, 1891; Zeeman, 1935). Prodromal cases can be defined pre-operatively as those in which the likelihood of lenticular complication is greater. The majority can be specifically diagnosed before surgery.