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Abstract #27341 Published in IGR 12-4

Retrospective case series on the long-term visual and intraocular pressure outcomes of phacomorphic glaucoma

Lee JWY; Lai JSM; Yick DWF; Tse RKK
Eye 2010; 24: 1675-1680

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PurposeTo analyse the long-term visual acuity (VA) and intraocular pressure (IOP) outcomes in phacomorphic glaucoma.Patients and methodsA retrospective analysis of 100 consecutive, acute phacomorphic glaucoma cases from January 2000 to April 2009 was conducted at The Caritas Medical Centre in Hong Kong. All cases underwent cataract extraction after IOP control with medication andor laser.ResultsDuring a 3.1(plus or minus)2.6-year follow-up, the mean visual improvement was 1.1(plus or minus)0.9 LogMAR units with improvements in 81.7 of cases. A shorter duration from symptoms to cataract extraction resulted in greater visual improvement (r(2)=0.1, P=0.001). In all, 80.5 of the cases had IOP21mmHg without any glaucoma treatment; 19.5 required 1.6(plus or minus)0.7 glaucoma eye drops; and 3.7 required additional laser iridotomy or trabeculectomy for IOP control at 1.8(plus or minus)2.3 years. The vertical cup-disc ratio (VCDR) of the index eye was 0.6(plus or minus)0.3. Gonioscopy revealed an averaged Shaffer grading of 3.0(plus or minus)1.0 and 99(plus or minus)90 degrees of peripheral anterior synechiae (PAS). The Humphrey automated perimetry mean deviation was 5.2(plus or minus)2.7 and the pattern standard deviation was 15.9(plus or minus)10.ConclusionOver 80 of phacomorphic patients had long-term visual improvements and normalization of IOP after cataract extraction. A shorter attack seemed to offer better VA. Post-operatively, most have open angles with some degree of PAS formation, and glaucomatous optic neuropathy is evident from enlarged VCDRs and visual field defects. At least 2 years of follow-up is useful to detect a 20 glaucoma progression possibly requiring additional glaucoma treatments. (copyright) 2010 Macmillan Publishers Limited. All rights reserved.

J. W. Y. Lee. Department of Ophthalmology, Caritas Medical Centre, Kowloon West Cluster, Hong Kong. jackywylee@gmail.com

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Classification:

9.4.4.5 Other (Part of: 9 Clinical forms of glaucomas > 9.4 Glaucomas associated with other ocular and systemic disorders > 9.4.4 Glaucomas associated with disorders of the lens)

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