Online Articles: Brief ReportsSlit-lamp Pars Plana Needle Hyaloidotomy-Zonulotomy-Iridotomy for the Treatment of Spontaneous Malignant GlaucomaThomas, Merina MD*; Boese, Erin A. MD†; Lieu, Philip MD‡; Shah, Manjool MD‡Author Information *Department of Ophthalmology, Casey Eye Institute, Oregon Health and Science University, Portland, OR †Department of Ophthalmology and Visual Sciences, University of Iowa, Iowa City, IA ‡Department of Ophthalmology and Visual Sciences, Kellogg Eye Center, University of Michigan, Ann Arbor, MI Disclosure: M.S. is a Consultant at Glaukos Corp and Allergan Inc. The remaining authors declare no conflict of interest. Reprints: Manjool Shah, MD, Kellogg Eye Center, University of Michigan, 1000 Wall Street, Ann Arbor, MI 48105 (e-mail: email@example.com). Journal of Glaucoma: May 2020 - Volume 29 - Issue 5 - p e31-e32 doi: 10.1097/IJG.0000000000001473 Buy Metrics Abstract An 88-year-old woman with a history of recent complicated pacemaker insertion presented with acute-onset malignant glaucoma recalcitrant to conservative medical therapy. Surgical intervention was discussed; however, given her complex cardiac history and recent postoperative state, the risk of anesthesia-related systemic adverse events was deemed unacceptably high. As such, a slit-lamp procedure was recommended to break the attack of malignant glaucoma. Here within, we report a novel technique of breaking an attack of malignant glaucoma by needling the anterior hyaloid face at the slit lamp. With this technique, a 25-G needle was entered through the pars plana and was advanced through the anterior hyaloid face, zonules, and peripheral iridotomy to create a unicameral eye and successfully break the malignant closure attack. Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.