VISUAL OUTCOME AND INTRAOCULAR PRESSURE CONTROL IN LENS INDUCED GLAUCOMAS FOLLOWING SURGERY
Journal Title: Journal of Evidence Based Medicine and Healthcare - Year 2019, Vol 6, Issue 12
Abstract
BACKGROUND Glaucoma is one of the preventable causes of blindness. Glaucoma may be primary or secondary. Lens induced glaucoma is one of the secondary glaucomas which is preventable. This study highlights the visual outcome and IOP reduction following surgery in various types of lens induced glaucomas. The aim of the study is to clinically analyse visual outcome and intraocular pressure control in lens induced glaucoma following surgery. MATERIALS AND METHODS 100 patients with lens induced glaucoma attending glaucoma services of Regional Institute of Ophthalmology and Government Ophthalmic Hospital Chennai were included in the study. All the patients were subjected to visual acuity examination. Anterior segment examination by slit lamp, IOP measurement, B scan where fundus examination is not possible and UBM in required cases. RESULTS In our study, most cases (52%) were in the age group of 56 -60 years. There was a slight male preponderance (59%). Maximum number of cases presented with very poor vision due to mature cataract and corneal oedema. Maximum cases (47%) presented with an IOP of 28-32 mmHg. Among 100 cases of lens induced glaucomas, 60% cases were phacolytic glaucomas, 29% were phacomorphic glaucomas, 10% were lens particle glaucomas, 1% was due to subluxated lens. Among 100 affected eyes, 50% had hyper mature cataract, 49% had mature cataract, 1% had immature cataract with subluxation. Maximum cases (72%) had PCIOL in other eye which was an important factor for late presentation to the hospital. All the patients were taken up for cataract extraction. The type of surgery depends on the type of lens induced glaucoma and was decided on the patient’s individual condition. At the end of six weeks the visual acuity for maximum number of cases (55%) was in the range of 6/36-6/18, 20% cases had vision in the range of 3/60-6/60, 20% cases had vision in the range of 6/12-6/9. Hence visual improvement occurred in 95% of cases at the end of sixth post-operative week. This is statistically significant (p<0.5). With regard to IOP reduction, at the end of 6th post-operative week, intraocular pressure (IOP) was in the range of 12-14 mmHg in 60% cases, 16-18 mmHg in 40% cases. CONCLUSION Lens induced glaucoma occurs due to long standing cataractous lens which becomes hyper mature/mature and also due to trauma. In our study, most of the patients had good vision in fellow eye and PCIOL status. This shows that patients ignored the reduced vision in affected eye due to good vision in fellow eye, so their daily life was not affected until they developed symptoms. Hence it is important to educate the patient postoperatively, to regularly follow up and examine the fellow eye and advice cataract surgery promptly before complications develop.
Authors and Affiliations
Chitra Munusamy Rajendran, Vimala Thangaraj, Saranya Dileep Vijayalakshmi
Keywords
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- EP ID EP615668
- DOI 10.18410/jebmh/2019/207
- Views 95
- Downloads 0
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