Visual acuity and intraocular pressure values in patients with phacomorphic glaucoma following phacoemulsification and intraocular lens implantation

Abstract

Objectives: To evaluate the efficiency of phacoemulsification and uncomplicated Intraocular Lens (IOL) implantation surgery on visual prognosis and intraocular pressure control on eyes with phacomorphic glaucoma. Materials and methods: Totally 17 eyes of 17 patients with phacomorphic glaucoma who underwent cataract surgery was evaluated retrospectively. Intraocular pressure (IOP), best corrected visual acuity, axial length, thickness of the lens and anterior chamber depth of the cases were measured preoperatively and postoperatively. Results: Ten cases (59 %) were male and 7 (41%) were female. The mean age of the cases was 63.8 ± 10.3 years (40-83). The average follow up period was 12.1 ± 6.7 months (3-26). Preoperative average intraocular pressure was 44.7 ± 10.02 mm Hg (30-70), and the average IOP in the last postoperative follow up was 12.8 ± 1.9 mm Hg (10-16). There was no IOP increase in any eye during follow up. Decrease in IOP in the first postoperative day was statistically significant (p

Keywords

• Phacomorphic glaucoma, phacoemulsification, intraocular lens implantation, intraocular pressure

Visual acuity and intraocular pressure values in patients with phacomorphic glaucoma following phacoemulsification and intraocular lens implantation

Abstract

Amaç: Cerrahi sırasında komplikasyon gelişmeyen fakomorfik glokomlu gözlerde uygulanan fakoemülsifikasyon ve göz içi lens (GİL) implantasyonu cerrahisinin görsel prognoz ve intraoküler basınç kontrolü üzerine olan etkinliğinin değerlendirilmesi. Gereç ve Yöntem: Katarakt ameliyatı uygulanan fakomorfik glokomlu 17 olgunun 17 gözü geriye dönük olarak değerlendirildi. Olguların pre ve post operatif olarak göz içi basıncı (GİB), düzeltilmiş en iyi görme keskinliği, aksiyel uzunluk, lens kalınlığı ve ön kamara derinliği ölçülerek karşılaştırıldı. Bulgular: Çalışmaya alınan 10 (%59) olgu kadın, 7\'si (%41) erkekti. Olguların yaş ortalaması 63.8±10.3 yıldı (40-83 yıl). Olguların ortalama takip süresi 12.1±6.7 aydı (3-26 ay). Preoperatif ortalama göz içi basıncı 44.7±10.02 mm Hg (30-70), postoperatif son kontroldeki ortalama GİB 12.8±1.9 mm Hg (10-16) olarak ölçüldü. Takip süresince hiçbir gözde GİB artışı izlenmedi. Postoperatif 1.günde GİB düşüşü istatistiksel olarak anlamlı bulundu( p

Keywords

• Fakomorfik glokom, fakoemülsifikasyon, göz içi lens implantasyonu, göz içi basıncı

References

1. Angra SK, Pradhan R,Gary SP. Cataract induced glauco- ma-an insight into management. Indian J Ophtalmology 1991;39(1):97-101.
2. Kolker A, Hetherington J. Becker-Shaffer’s Diagnosis and Therapy of the Glaucomas 5th ed. The CV Mosby Co. St Louis, 1983, P:201-3.
3. David R, Tessler Z, Yassur Y. Long term outcome of pri- mary acute angle closure glaucoma. Br J Ophthalmol 1993;17(1):33-6.
4. Kanellopoulos AJ, Perry HD, Donnenfeld ED. Comparison of topical timolol gel to oral acetazolamide in the prophy- laxis of viscoelastic-induced ocular hypertension after pen- etrating keratoplasty. Cornea 1997;16(1):12-5.
5. Hart WM, Becker B. The onset and evolution of glaucoma- tous visual field defect. Ophthalmology 1982;89(8):991-8.
6. Tomey KF, Al-Rajhi AA. Neodynium:YAG laser irridotomy in the initial management of phacomorphic glaucoma. Oph- thalmology 1992;99(5):660-5.
7. Gimbel HV, Willerscheidt AB. What to do with limited view: the intumescent cataract. J Cataract Refract Surg 1993;19(6):657-61.
8. Gogate PM, Deshpande M, Wormald RP, et al. Extrakapsu- lar cataract surgery compared with manual small incision cataract surgery in community eye caresetting in west- ern India: A randomised controlled trial. Br J Ophthmol 2003;87(6):667-72.

9. Tomlinson A, Leighton DA. Ocular dimensions in the he- redity of angle-closure glaucoma. Br J Ophthalmol 1973;57(4):475-86.
10. Markowitz SN, Morin JD. The ratio of lens thickness to axial length for biometric standardization in angle-closure glaucoma. Am J Ophthalmol 1985;99(4):400-2.
11. Lin YW, Wang TH, Hung PT. Biometric study of acute primary angle-closure glaucoma. J Formos Med Assoc 1997;96(8):908- 12.
12. Qi Y: Ultrasonic evaluation of the lens thickness to axial length factor in primary closure angle glaucoma. Yan Ke Xue Bao 1993;9(1):12-4.
13. Lee JW, Lai JS, Wong BK, et al. Retrospective analysis of the risk factors for developing phacomorphic glaucoma. In- dian J Ophthalmol 2011;59(4):471-4 .
14. Chandler PA, Grant WM: Lectures on Glaucoma. PA, Lea & Febiger, Philadelphia, 1965; 403-40.
15. Shields MB, Simmons RJ. Combined cyclodialysis and cat- aract extraction. Trans Am Acad Ophthalmol Otolaryngol 1976;81(2):286-97.
16. Galin MA, Baras I, Sambursky J. Glaucoma and cataract; a study of cyclodialysis lens extraction. Am J Ophthalmol 1969; 67(4):522-6.
17. Harrington DO. Cataract and glaucoma; management of coexistent conditions and a description of a new operation combining lens extraction with reverse cyclodialysis. Am J Ophthalmol 1966;61(9):1134-40.
18. Chandler PA, Maumenee AE. A major cause of hypotony. Am J Ophthalmol 1961;52(5):609-18.
19. Lee SJ, Lee CK, Kim WS. Long-term therapeutic efficacy of phacoemulsification with intraocular lens implantation in patients with phacomorphic glaucoma J Cataract Refract Surg 2010;36(6):783-9.
20. Mansour AM. Anterior capsulorhexis in hypermature cata- racts [letter]. J Cataract Refract Surg 1993;19(1):116-7.
21. Horiguchi M, Miyake K, Ohta I, et al. Staining of the lens capsule for circular continuous capsulorhexis in eyes with white cataract. Arch Ophthalmol 1998;116(4):535-7.
22. Rao SK, Padmanabhan P. Capsulorhexis in eyes with phacomorphic glaucoma. J Cataract Refract Surg 1998; 24(7):882-4.
23. Chakrabarti A, Singh S, Krishnadas R: Phacoemulsifica- tion in eyes with white cataract. J Cataract Refract Surg 2000;26(9):1041-7.
24. PrajnaNV, RamakrishnanR, KrishnadasR, et al. Lens in- duced glaucoma-visual results and risk factors for final vi- sual acuity. Indian J Ophthalmol 1996;44(1):149-55.
25. Lee JWY, Lai JSM, Yick DWF, et al. Retrospective case series on the long-term visual and intraocular pressure out- comes of phacomorphic glaucoma. Eye 2010;24(8):1675- 80.
26. Civerchia LL, Balent A. Intraocular lens implantation in acute angle closure glaucoma associated with cataract. Am Intra-Ocular Implant Soc J 1985;11(2):171-3.
27. McKibbin M, Gupta A, Atkins AD. Cataract extraction and intraocular lens implantation in eyes with phaco- morphic or phacolytic glaucoma. J Cataract Refract Surg 1996;22(5):633-6.