This 56 year-old man
suffered from right acute angle closure glaucoma. Goniocopy showed
peripheral anterior synechiae and the intraocular pressure could not be
controlled with laser iridotomy. Trabeculectomy was performed and the
intraocular pressure was lowered to 10 mmHg with only topical steroid.
Laser iridotomy may not be
successful in acute angle closure glaucoma if the eye developed extensive
peripheral anterior synechiae. The treatment of choice in such cases is
Fornix based trabeculectomy.
Slit-lamp view of glaucofleckens.