Posters

Bilateral angle-closure glaucoma revealing nanophthalmos

Poster Details

First Author: I.Ouasti ALGERIA

Co Author(s):    T. Kandoussi   L. Lazreg   O. Oukebdane   N. Ouslim           

Abstract Details

Purpose:

To report a clinical feature of bilateral angle-closure glaucoma in a patient with nanophthalmic eyes treated by argon laser gonioplasty and cataract surgey, and to describe the imporvement of  visual outcome after cataract surgery despite complications.

Setting:

Ouasti I, Kandoussi T, Lazreg L, Oukebdane W, Ouslim N ( Etablissement hospitalier et universitaire d'iophtalmologie front de mer, Oran, Algérie)  public hospital

Methods:

A 54-year-old white male was referred urgentely for an acute angle closure crisis in OS. Ocular examination revealed isohyperopia (+11.75 diopters) with reduced axial length (17.07 mm OD and 16.58 mm OS). His IOP measured 25 mmHg OD and 50 mm Hg OS. Slit-lamp biomicroscopy showed microcornea. Anterior chamber depths were shallow. A great white cataract OS. Gonioscopy revealed an extremely narrow angle with peripheral anterior synechiae. Fundus examination disclosed punctate hypopigmentation of the retina. Echography revealed thickened sclera. The patient had a family history of hyperopia. We diagnosed nanophtalmos. he received argon laser gonioplasty OD and catract surgery OS

Results:

Nanophthalmic eyes develop slow, painless, progressive elevation of IOP in middle age. Often associated with growth of lens size, therefore they should be followed carefully for signs of progressive angle narrowing demanding early laser iridotomy or gonioplasty before complications occur. Surgery should be avoided eyes unless absolutely necessary for the visual outncome, as in the case of our patient who had undergone phacomulsification+ IOL. Our patient presented early anterior capsule contraction syndrome easily resolved by Nd:Yag laser capsulotomy. No relapses occurred during the follow-up of 12 months. Visual acuity OS improved from « hand motion » to 20/80

Conclusions:

Nanophtalmos are often revealed at a stage of complications, they are  high-risk eyes for surgery but with advances in cataract and glaucoma treatments, surgical results in patients with nanophthalmos are improving

Financial Disclosure:

None