A PROSPECTIVE STUDY ON VISUAL OUTCOME, IOP CONTROL AND COMPLICATIONS IN PATIENTS WITH LENS-INDUCED GLAUCOMA FOLLOWING MANUAL SICS IN A TERTIARY HEALTH CENTRE
Journal Title: Journal of Evolution of Medical and Dental Sciences - Year 2017, Vol 6, Issue 93
Abstract
BACKGROUND Lens-induced glaucomas are a common occurrence in rural areas of India (Assam). A prospective study was done to analyse the visual outcome, intraocular pressure control and complications in patients with lens-induced glaucoma following manual small incision cataract surgery. The objective of this study is to analyse the visual outcome, intraocular pressure control and complications in patients with lens-induced glaucoma following manual SICS in a tertiary health centre. MATERIALS AND METHODS The present observational study was conducted in the Department of Ophthalmology, Fakhruddin Ali Ahmed Medical College and Hospital, Barpeta from September 2015 to August 2017. The study group included 68 patients clinically diagnosed as lens-induced glaucoma. Detailed history and thorough clinical examination of both eyes including visual acuity, Schiotz tonometry, slit-lamp biomicroscopy, fundus examination and gonioscopy were done. Cases were managed both medically and surgically. After control of IOP, manual small incision cataract surgery with PCIOL implantation with or without iridectomy was done under local (peribulbar) anaesthesia in all cases. Informed and written consents were taken. Data was recorded in a preformed proforma. RESULTS Out of 68 patients with LIG, majority of the patients were phacomorphic glaucoma (60.2%) followed by phacolytic glaucoma (29.4%). Most common age group affected was 51 - 60 years (35.2%). Incidence of LIG was more among females (55.88%) than males (44.11%). Majority of cases numbering 28 (41.2 %) had IOP between 41 - 50 mmHg at the time of presentation. While following operation after 3 months, most of the cases numbering 63 (92.6%) had IOP less than 21 mmHg. At presentation, only 4 (5.9%) cases had visual acuity between 6/6 - 6/18 and 3 months following operation 34 (50%) had visual acuity between 6/6 - 6/18. It was observed that out of 26 cases who presented within 5 days, 20 cases (76.9%) had good vision, i.e. between 6/6 - 6/18, while in 14 cases who presented after 10 days none of them had good vision and amongst them 5 (35.7%) had vision between 6/18 - 6/60 and 9 (64.3%) had poor vision > 6/60. The common complications encountered were uveitis (7.4%), PCR with vitreous loss (4.4%), posterior capsular opacity (4.4%), bullous keratopathy (2.9%) and cystoid macular oedema (1.47%). CONCLUSION It can be concluded that manual SICS is safe and effective in controlling IOP and attaining good functional visual recovery in the management of LIG. Surgical removal of lens with IOL implantation is the most effective treatment in a patient with LIG. Glaucoma secondary to hypermature cataract can be saved by prompt removal of the cataract. Earlier is the lens extraction, better is the visual and IOP outcome.
Authors and Affiliations
Sewali Das, Mritunjay Sharma
Keywords
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- EP ID EP279574
- DOI 10.14260/jemds/2017/1462
- Views 92
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