Long-term therapeutic efficacy of phacoemulsification with intraocular lens implantation in patients with phacomorphic glaucoma

Abstract

Purpose: To evaluate the long-term therapeutic efficacy of phacoemulsification with intraocular lens (IOL) implantation in treating phacomorphic glaucoma.

Setting: Ophthalmology Department, Maryknoll Hospital, Busan, Korea.

Methods: This study evaluated eyes that had phacoemulsification with IOL implantation to treat phacomorphic glaucoma. Intraocular pressure (IOP), corrected distance visual acuity (CDVA), and anterior chamber depth (ACD) were measured preoperatively and postoperatively. The minimum follow-up was 48 months.

Results: The mean IOP in the 26 eyes was 49.0 mm Hg +/- 10.4 (SD) (range 31 to 70 mm Hg) preoperatively and 13.2 +/- 2.8 mm Hg (range 8 to 20 mm Hg) 48 months postoperatively (P<.0001, paired t test). No eye had increased IOP over the follow-up. The postoperative IOP was significantly lower 1 day postoperatively (P<.000, paired t test). The improvement in CDVA was statistically significant from 1 week postoperatively (P<.0001, paired t test). The CDVA improved postoperatively except in 1 eye with a preoperative acuity of no light perception. The CDVA was 20/50 or better in 16 eyes (61.5%). Preoperatively, the ACD was shallow (mean 1.5 +/- 0.3 mm) because of the swollen lens; the mean postoperative ACD was 2.6 +/- 0.1 mm; the increase was statistically significant. The mean preoperative ratio of lens thickness to axial length was 0.25 +/- 0.01, indicating a shallow ACD. In 1 eye, peripheral anterior synechias were seen on gonioscopy immediately after surgery; the eye required continuous postoperative medication for IOP control.

Conclusion: Phacoemulsification with IOL implantation was effective in treating phacomorphic glaucoma.