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Abstract #5739 Published in IGR 2-1
Lens subluxation and glaucoma: indications and hazards of cataract surgery
Haeberle H; Pham DT; Weller AOphthalmologe 2000; 97:47-50
BACKGROUND: Iridodonesis is the clinical sign of lens subluxation. Acute glaucoma caused by a ciliolenticular block may develop. YAG iridotomy or peripheral iridectomy are rarely effective in controlling intraocular pressure. The results of phacoemulsification and posterior lens implantation for subluxated lens and glaucoma are reported. PATIENTS AND METHODS: Seven patients aged 69±9.5 years were followed up. All ten eyes with subluxated lens and glaucoma had phacoemulsification and posterior chamber lens implantation. Two different groups relating to axial length could be analyzed. Intraoperative findings and postoperative glaucoma situation are reported. RESULTS: Six eyes had an average axial length of 21.5±0.17 mm and previous acute glaucoma. Five of these eyes had therapeutic YAG iridotomy and one, peripheral iridectomy. All eyes had dysregulated glaucoma despite antiglaucomatous medications. After cataract surgery five of six eyes had regular intraocular pressure without any medication. Four eyes had average an axial length of 24.4±1.1 mm and chronic glaucoma. After complicated phacoemulsification, three of these eyes had regular intraocular pressure with antiglaucomatous medication, one eye without. CONCLUSIONS: For short eyes with a subluxated lens and preceding acute glaucoma, cataract surgery with posterior chamber lens implantation is an effective therapeutic procedure for IOP regulation. For chronic glaucoma with a subluxated lens, the conventional or surgical approach to glaucoma remains the most common. LA: German
Dr. H. Haeberle, Augenabteilung Krankenhaus Neukoelln, Berlin, Germany
Classification:
9.4.4.3 Glaucomas associated with lens dislocation (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)