Posters

Selecting the way of the IOP normalisation in patients after an acute attack of angle-closure glaucoma

Poster Details

First Author: O.Goncharenko RUSSIA

Co Author(s):    S. Sakhnov   A. Martsinkevich                 

Abstract Details

Purpose:

To study the effiсacy of reducing IOP after the lens extraction in combination with iridoplasty in patients following acute attack of angle-closure glaucoma.

Setting:

S. Fyodorov Eye Microsurgery Complex The Krasnodar branch, Krasnodar, Russia

Methods:

32 patients (32 eyes) after an acute attack of angle-closure glaucoma (ACG) in the period from several days to 6 months were observed in present study (mean age, 69.7±7.3 y). All of them underwent uneventful phacoemulsification with goniosynechia separation and pupilloplasty by imposing a circular suture. The anterior and posterior chamber (AC and PC) depth, the lens thickness and its position relative to the cornea were assessed by UBM and AS-OCT. The follow-up period after surgery was from 6 months to 2 years.

Results:

The mean IOP was 29.96±6.01 mmHg (range: 26-41 mmHg) before surgery, and it reduced to 14.57±2.01 mmHg (P<0.005) after surgery. The mean BCVA before surgery was 0.18±0.14, and after surgery it increased to 0.66±0.12 (P<0.005). Postoperative complications were observed in 5 eyes (17.2%): 3 – exudative-inflammatory reaction of the anterior segment of the eye (10.3%), 2 – hypotension with serous choroidal detachment (6.9%), - and were stopped by medication within 3-5 days. Two patients in 1.5 months after surgery was required additional appointment of hypotensive eye drops, and 1 of them in 1 year was performed trabeculectomy.

Conclusions:

According to UBM, on the 3rd day after surgery in all patients there was observed a significant depression of the AC (in 1.5-2 times), opening of the AC angle, increasing of the PC and repositioning of ciliary processes with respect to the iris plane. In this way the timely extraction of the lens combined with the goniosynechia separation and pupilloplasty by imposing a circular suture, promotes a persistent reduced in IOP, improved visual functions and restoring the correct anatomic topographical relationship of the anterior segment structures of the eye.

Financial Disclosure:

None