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Abstract #71442 Published in IGR 18-3
Glaucoma and intraocular pressure in patients operated for late in-the-bag intraocular lens dislocation: a randomized clinical trial
Kristianslund O; Råen M; Østern AE; Drolsum LAmerican Journal of Ophthalmology 2017; 176: 219-227
PURPOSE: To compare intraocular pressure (IOP) and IOP-lowering treatment requirements in patients with late in-the-bag intraocular lens (IOL) dislocation operated with 2 different methods, and to assess whether an IOP decrease after surgery can be expected. DESIGN: Prospective, randomized, parallel-group clinical trial. METHODS: In our university clinic, 104 patients (eyes) were randomly assigned to IOL repositioning by scleral suturing (n = 54) or IOL exchange with retropupillar iris-claw lens (n = 50). The main outcome measure was 6-month postoperative IOP change. RESULTS: Overall IOP was 18.0 ± 6.2 mmHg before surgery and 15.7 ± 4.8 mmHg 6 months after surgery (P < .001). IOP changed by -1.2 ± 5.8 mmHg in the repositioning group (P = .18) and -3.8 ± 6.4 mmHg (P < .001) in the exchange group (group difference: P = .05). Before surgery, 62 patients had either preexisting glaucoma (n = 39) or high IOP (≥ 22 mmHg) with suspected glaucoma (n = 23), of whom several required preoperative IOP-lowering treatment. In the postoperative period, 28% and 21% of the patients in each operation group, respectively, required IOP-lowering treatment with glaucoma medications added, adjunctive laser trabeculoplasty, cyclodiode laser or filtering surgery. Only 0 and 3 patients, respectively, discontinued their IOP-lowering medication. CONCLUSIONS: This trial showed an IOP decrease after late in-the-bag IOL dislocation surgery that seemed to be more pronounced with IOL exchange. However, associated high IOP was not resolved by dislocation surgery in many patients, and increased IOP-lowering treatment in the postoperative course was commonly required.
Department of Ophthalmology, Oslo University Hospital, Norway, Address: Mailbox 4956 Nydalen, 0424 Oslo, Norway; Institute of Clinical Medicine, University of Oslo, Norway, Address: Mailbox 1171, Blindern, 0318 Oslo, Norway. Electronic address: olav.kristianslund@gmail.com.
Full articleClassification:
9.4.11.2 Glaucomas in aphakia and pseudophakia (Part of: 9 Clinical forms of glaucomas > 9.4 Glaucomas associated with other ocular and systemic disorders > 9.4.11 Glaucomas following intraocular surgery)
