Purpose To investigate the preoperative anterior segment structural features in eyes diagnosed with malignant glaucoma (MG) following primary angle‐closure glaucoma (PACG) surgery and to provide a clinical reference for the early detection of the risks of MG. Methods A retrospective case–control study. The study population included two groups: the MG group (17 patients, 21 eyes), consisting of eyes with postoperative MG, and the No‐MG group (24 patients, 30 eyes), consisting of eyes with no MG. All patients underwent combined surgery for glaucoma and cataract (phacoemulsification cataract extraction combined with intraocular lens implantation plus goniosynechialysis PEI + GSL).The groups were matched for age, gender, and clinical condition. Ultrasound biomicroscopy (UBM) was used to measure anterior segment parameters, including anterior chamber depth (ACD), anterior chamber width (ACW), trabecular‐ciliary process distance (TCPD), ciliary–ciliary distance (CCD), iris–zonule distance (IZD), trabecular‐ciliary process angle a (TCA a ), trabecular‐ciliary process angle b (TCA b ), iris–ciliary process distance (ICPD), maximum ciliary body thickness (CBT max ), ciliary body thickness at a distance of 1000 mm (CBT 1000 ), and vitreous zonule (VZ). Results ACD, ACW, CCD, TCPD, IZD, ICPD, TCA a , TCA b , CBT max , and CBT 1000 were smaller in MG compared to No‐MG eyes ( p < 0.05). Multifactorial logistic regression analysis identified two significant risk factors for developing MG: narrower TCA b (odds ratio OR = 0.761; 95% confidence interval CI, 0.600–0.964, p < 0.05) and smaller VZ (OR = 0.076; 95% CI, 0.007–0.836, p < 0.05). Conclusion Eyes with PACG having MG exhibit specific anatomical risk factors, including a more crowded anterior chamber space, greater forward displacement of the ciliary body, and more breaks in the VZ. VZ plays a very important role in the pathogenesis of MG.
Liu et al. (Thu,) studied this question.