Posters

Two-stage approach surgical treatment of cataract and glaucoma in a patient with severe scleromalacia

Poster Details

First Author: O.Ermakova RUSSIA

Co Author(s):    A. Lazareva                    

Abstract Details

Purpose:

To show the possibility of achieving good visual acuity and intraocular pressure (IOP) compensation in the 2 step treatment of cataracts and glaucoma using MicroPulse cyclophotocoagulation IRIDEX G6.

Setting:

Multidisciplinary Science and Technology Complex Eye Microsurgery named after Academician S. N. Fyodorov, Federal State Institution, Novosibirsk Branch, Russia.

Methods:

The patient is a 78 y.o. female with long-standing rheumatoid arthritis. Total Scleromalacia with perforation OD and total Scleromalacia without perforation OS in the visible area of the sclera. Diagnosis: Cataracts, secondary glaucoma of both eyes. Visual acuity: right eye is blind, left eye: 20/200. IOP 32/35 mm Hg during eye-drop treatment (dorzlamide + timolol). The sclera is thin (300 mkm on ultrasound biometry (UBM)) around the entire limb and dark uveal tissue is almost visible. At the 1st stage, cataract phacoemulsification with implantation of an intraocular lens (IOL), at the 2nd stage MicroPulse cyclophotocoagulation IRIDEX CYCLOG6 were performed.

Results:

There were no complications after 1st stage surgical treatment. Postop visual acuity was 20/25 (Snellen), IOP OS 28 mm Hg during eye-drop treatment (dorzlamide + timolol). 2nd stage surgical treatment was performed through 5 days. We reduced laser energy of MicroPulse cyclophotocoagulation IRIDEX CYCLOG6 to 1800 mW, however it caused conjunctival and scleral burn. Then energy was reduced to 1300 mW for the second hemisphere, conjunctival and scleral tissue remained intact. The visual acuity OS after cyclophotocoagulation was 20/25. IOP after 1 day, 1 and 3 months was 16 mm Hg. The result remains stable.

Conclusions:

The chosen two-stage approach using micropulse cyclophotocoagulation made it possible to increase visual acuity and achieve normal IOP in a patient with a single seeing eye with severe scleromalacia. MicroPulse cyclophotocoagulation is effective and safety in cases of scleramalation, but we must reduce the laser energy and select it individually.

Financial Disclosure:

None