Clear lens extraction as an prophylactic treatment option for narrow chamber angle with or without glaucoma

Session Details

Session Title: Glaucoma

Session Date/Time: Monday 09/10/2017 | 08:00-10:30

Paper Time: 08:54

Venue: Room 4.1

First Author: : A.Liekfeld GERMANY

Co Author(s): :    S. Nincke   C. Hermsdorf                 

Abstract Details

Purpose:

To evaluate the therapeutic effect and possible side effects of clear lens extraction (CLE) instead of laser iridotomy in patients with a narrow chamber angle and risk of angle closure with or without glaucoma.

Setting:

eye clinic, Klinikum Ernst von Bergmann gGmbH, Potsdam, Germany

Methods:

52 eyes that had undergone clear lens extraction because of anatomical situation were evaluated retrospectively concerning visual acuity, refraction, intraocular pressure (IOP) and number of intraocular pressure lowering eyedrops. Preoperatively the average anterior chamber angle width was Shaffer 1.34, the average axial length was 22.23 mm and the average lens thickness was 4.6mm. Also patients with laser iridotomy prior to the CLE were evaluated separately.

Results:

IOP could be reduced by 3.19 (± 3.85) mmHg on average, in patients with prior laser iridotomy by 3.17 (± 2.23) mmHg. Eyes with preoperative IOP > 20 mmHg the average reduction was even higher with 6.62 (± 3.4) mmHg. A significant average reduction of IOP lowering eyedrops by a number of 0.83 (± 1.06) was observed. Best corrected visual acuity did not change, while uncorrected visual acuity (UCVA) improved significantly (preoperative: 0.34 (± 0.27); postoperative 0.66 (± 0.25)). Also the spherical equivalent was significantly reduced from + 1.97 dioptres (D) to – 0.4D. No severe complications occurred.

Conclusions:

Patients with an anatomical risk of closed angle glaucoma benefit from early lens extraction in terms of IOP lowering and reduction of eyedrops besides an improved UCVA. We recommend primary clear lens extraction instead of laser iridotomy in these eyes.

Financial Disclosure:

NONE