scholarly journals Effective treatment for secondary angle-closure glaucoma caused by traumatic lens subluxation: phacoemulsification with capsular-tension-ring implantation combined with ophthalmic endoscope-controlled goniosynechialysis

2021 ◽  
Vol 14 (10) ◽  
pp. 1548-1552
Author(s):  
Qi Dai ◽  
◽  
Xin-Yi Liu ◽  
Wei-Hua Pan ◽  
◽  
...  
Keyword(s):  
Angle Closure Glaucoma ◽  
Angle Closure ◽  
Posterior Chamber ◽  
Glaucoma Medication ◽  
Lens Subluxation ◽  
Capsular Tension Ring ◽  
Corrected Visual Acuity ◽  
Posterior Chamber Intraocular Lens ◽  
The Average Range

AIM: To investigate the safety and efficacy of phacoemulsification with capsular-tension-ring implantation and posterior chamber intraocular lens implantation combined with ophthalmic endoscope-controlled goniosynechialysis (Phaco-CTR-IOL-OE-GSL) for treating secondary angle-closure glaucoma induced by traumatic lens subluxation. METHODS: A retrospective and descriptive study was performed on patients with lens subluxation, angle closure, goniosynechia, and evaluated intraocular pressure (IOP) that cannot be controlled with medication, who underwent Phaco-CTR-IOL-OE-GSL. The postoperative best-corrected visual acuity (BCVA), IOP, range of goniosynechia and complications were retrospectively observed. RESULTS: Nine patients with secondary angle-closure glaucoma induced by traumatic lens subluxation were included. The follow-up period was 51.1±8.6mo. The preoperative range of zonule rupture was 158.2°±33.0°, and the range of goniosynechia was 220.0°±92.5°. The baseline BCVA was 0.9±1.0 logMAR, IOP was 30.7±17.3 mm Hg, and number of anti-glaucoma medication was 3.2±1.1. Mild intraoperative hyphaemia with 8 eyes (88.8%) in the anterior chamber, and was absorbed two days postoperatively. One eye (11.1%) had postoperative ciliary body detachment and was recovered after five days of topical drug treatment. BCVA was 0.2±0.2 logMAR at 3mo postoperatively. The average IOP at the last follow-up was 16.7±2.0 mm Hg, and no anti-glaucoma medications were used. The average range of recurrent goniosynechia was 54.9°±33° at the final postoperative gonioscopic examination. CONCLUSION: Phaco-CTR-IOL-OE-GSL is safe and effective in the treatment of secondary angle-closure glaucoma induced by traumatic lens subluxation. The use of an endoscope provides a more direct and clear examination for GSL, and 360° dissection is easily achieved.

scholarly journals Primary Outcomes of Patients with Chronic Angle-Closure Glaucoma Treated with Combined Phacoemulsification, Viscogoniosynechialysis, and Endocyclophotocoagulation

2019 ◽  
Vol 2019 ◽  
pp. 1-5
Author(s):  
Juan Carlos Izquierdo Villavicencio ◽  
Natalia Agudelo Arbelaez ◽  
Bárbara Rubio Lastra ◽  
Imelda Ramirez ◽  
Fabiola Quezada ◽  
...  
Keyword(s):  
Surgical Intervention ◽  
Combined Treatment ◽  
Angle Closure Glaucoma ◽  
Angle Closure ◽  
Glaucoma Medication ◽  
Yag Laser ◽  
Corrected Visual Acuity ◽  
Lens Implantation ◽  
Best Corrected Visual Acuity

Purpose/Objective. To evaluate the effectiveness of combined phacoemulsification, viscogoniosynechialysis (VGSL), and endocyclophotocoagulation (ECP) in patients with moderate chronic angle-closure glaucoma (CACG) with peripheral anterior synechia (PAS) ≥90 not controlled with glaucoma medications and previous iridotomy yag laser. Materials and Methods. We retrospectively reviewed records from patients with cataract and uncontrolled chronic angle-closure glaucoma despite maximal tolerated medical therapy and iridotomy yag laser who received combined treatment with phacoemulsification with posterior capsular lens implantation, VGSL, and ECP 360°. We evaluated intraocular pressure (IOP), glaucoma medications, and best corrected visual acuity (BCVA) preoperatively and during follow-up.Results. A total of 29 eyes from 22 patients received surgical intervention. Mean follow-up was 6 months. Mean preoperative IOP was 18.2 mmHg, and postoperatively, IOP was 13.5, 12.2, and 12.8 mmHg at 1, 3, and 6 months, respectively. Complete success was 37.9%, and relative success was 72.4%. Mean BCVA was 0.4 logMAR preoperative and 0.3 logMAR 6 months after surgery. Glaucoma medication fell significantly from 2.34 ± 1.66 preoperatively to 1.31 ± 2.6 postoperatively p<0.001. Overall, 44.8% of the patients did not require glaucoma medications at 6 months. There were no visual significant complications. Conclusion. Combined treatment with phacoemulsification with posterior capsular lens implantation, VGSL, and ECP is effective and safe in reducing IOP and number of glaucoma medications with stable BCVA at 6 months.

scholarly journals Management of bilateral microspherophakia with secondary angle closure glaucoma

2015 ◽  
Vol 7 (1) ◽  
pp. 69-73
Author(s):  
K PS Malik ◽  
R Goel ◽  
K Jain ◽  
S Nagpal ◽  
S Singh
Keyword(s):  
Visual Acuity ◽  
Angle Closure Glaucoma ◽  
Angle Closure ◽  
Posterior Chamber ◽  
Middle Aged ◽  
Aged Patients ◽  
Posterior Chamber Intraocular Lens ◽  
Shallow Anterior Chamber ◽  
The Right

Background: Microspherophakia is characterized by lenticular myopia, late development of lens dislocation, shallow anterior chamber and angle-closure glaucoma. If it is associated with angle closure glaucoma, the management can be challenging.Objective: To report the management of a case of bilateral secondary angle closure glaucoma with isolated microspherophakia and right subluxated lens in a middle aged lady. Case: A 47-year-old female presented with bilateral secondary angle closure glaucoma with isolated microspherophakia, right subluxated lens and left operated trabeculectomy. The patient`s best corrected log mar visual acuity improved from 1.0 to 0.2 and intraocular pressure (IOP) decreased from 24.9mm of Hg to lower teens following lensectomy with scleral ¿xation of posterior chamber intraocular lens in the right eye. The left eye IOP remained in mid teens without medication in two year follow up. Conclusion: This case demonstrates that microspherophakia should be ruled out even in middle aged patients presenting as angle closure glaucoma. The possibility of thickened cornea must be kept in mind requiring an IOP correction. Lensectomy with scleral ¿xation of posterior chamber IOL provides a satisfactory recovery of visual acuity and IOP control. Though in this patient, the lens was held in position by posterior synechiae in the left eye, future stability of zonules needs to be monitored.

scholarly journals Combined Phacoemulsification and Goniosynechialysis under an Endoscope for Chronic Primary Angle-Closure Glaucoma

2018 ◽  
Vol 2018 ◽  
pp. 1-7 ◽  
Author(s):  
Li Nie ◽  
Weihua Pan ◽  
Aiwu Fang ◽  
Zhangliang Li ◽  
Zhenbin Qian ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Anterior Segment ◽  
Angle Closure Glaucoma ◽  
Angle Closure ◽  
Primary Angle Closure ◽  
Primary Angle Closure Glaucoma ◽  
Corrected Visual Acuity ◽  
Corneal Endothelial Cell Density ◽  
The Mean

Purpose. To investigate the clinical efficacy and safety of combined phacoemulsification with goniosynechialysis (GSL) under an ophthalmic endoscope for chronic primary angle-closure glaucoma and coexisting cataract. Methods. This is a retrospective study. The intraocular pressure (IOP), best-corrected visual acuity (BCVA), and number of glaucoma medications at baseline and each postoperative follow-up visit were recorded. Other measurements included supraciliochoroidal fluid measured by anterior segment optical coherence tomography, corneal endothelial cell density (ECD), and peripheral anterior synechia (PAS). All patients were followed for more than a year. Results. Thirty-eight eyes of 31 patients were included. The mean follow-up duration was 16.3 ± 3.9 months. The IOP decreased from 22.2 ± 9.3 mmHg at baseline to 15.4 ± 4.2 mmHg at the last follow-up (P<0.001). The mean number of glaucoma medications (0.1 ± 0.6) at the last follow-up was significantly lower than the preoperative number (2.3 ± 1.1) (P<0.001). All patients achieved improved or stable visual acuity after surgery. All patients achieved a complete opened angle after GSL. The postoperative complications included hyphema (7.9%), exudation (5.3%), transiently elevated IOP (55.3%), and supraciliochoroidal fluid (40%). Conclusions. Combined phacoemulsification and GSL under an endoscope can completely reopen PAS and is an effective and safe method for patients with chronic primary angle-closure glaucoma and coexisting cataract.

scholarly journals Accidental intralenticular sustained-release dexamethasone (Ozurdex) implantation: A case report

2021 ◽  
pp. 360-362
Author(s):  
Chaitali Basu ◽  
Rakesh Jha
Keyword(s):  
Sustained Release ◽  
Macular Edema ◽  
Rare Complication ◽  
Posterior Chamber ◽  
Dexamethasone Implant ◽  
Posterior Subcapsular Cataract ◽  
Anterior Vitrectomy ◽  
Corrected Visual Acuity ◽  
Posterior Chamber Intraocular Lens

Intravitreal implantation of Ozurdex (Allergan Inc., Irvine, CA, USA), a sustained-release dexamethasone implant, is a common practice in ophthalmology. Inadvertent intralenticular implantation of Ozurdex is a very rare complication. Herein, we report a case of accidental intralenticular Ozurdex implantation. During the intravitreal procedure, the patient moved his head vigorously which resulted in the said complication. He was followed up periodically with monitoring of intraocular pressure (IOP), best-corrected visual acuity, lens status, fundus, and macular edema status. He developed a posterior subcapsular cataract after about 5 months of the procedure. The cataract was removed around 6 months follow-up by phacoemulsification with anterior vitrectomy and implantation of a 3-piece posterior chamber intraocular lens in the ciliary sulcus. Macular edema had resolved by 3 months of Ozurdex implantation and the patient did not require a second intravitreal dose. He was well at 3 months follow up after cataract surgery.

scholarly journals Capsular Bag Distension Syndrome Following Phacoemulsification with Implantation of Intraocular Lens

2020 ◽  
Vol 15 (2) ◽  
pp. 306-312
Author(s):  
Safinaz Mohd Khialdin ◽  
Keyword(s):  
Intraocular Lens ◽  
Rare Complication ◽  
Posterior Chamber ◽  
Poor Vision ◽  
Post Surgery ◽  
Corrected Visual Acuity ◽  
Posterior Chamber Intraocular Lens ◽  
The Right ◽  
Capsular Bag

Capsular bag distension syndrome is a rare complication following phacoemulsification with posterior chamber intraocular lens implantation. We describe the case of a middle-age male, who developed early onset capsular bag distension syndrome of the right eye after phacoemulsification with implantation of plate haptic posterior chamber intraocular lens (Zeiss CT ASPHINA 509MP). There was persistent poor vision during follow up at 1 week and 5 weeks post-surgery with a myopic shift of 2.5 diopters sphere (DS). The intraocular pressure was only elevated at 2 hours post-operative and was normal during the subsequent followup. Distension of capsular bag was confirmed with the IOP Master 700 which showed abnormal separation of posterior capsule from the intraocular lens. He was diagnosed with capsular bag distension syndrome secondary to retention of viscoelastic. Right eye removal of retained viscoelastic was performed and the capsular bag distension syndrome resolved successfully with best corrected visual acuity at 6/6. Hence, complete clearance of viscoelastic during phacoemulsification with plate haptic intraocular lens is important in order to prevent capsular bag distension syndrome.

scholarly journals Sub-conjunctival dislocation of posterior chamber intra-ocular lens: five years after manual, small-incision cataract surgery

2014 ◽  
Vol 6 (1) ◽  
pp. 91-94
Author(s):  
Rajesh Subhash Joshi
Keyword(s):  
Cataract Surgery ◽  
Wound Closure ◽  
Wound Dehiscence ◽  
Posterior Chamber ◽  
Small Incision Cataract Surgery ◽  
Small Incision ◽  
Corrected Visual Acuity ◽  
Scleral Tunnel ◽  
Posterior Chamber Intraocular Lens

Introduction: Ocular trauma can cause serious complications in eyes operated for cataract. Case: A 70-year- old lady had sustained blunt trauma to the left lower lid which resulted in a sub-conjunctival dislocation of the posterior chamber intraocular lens (PCIOL). The patient had undergone an uneventful manual, small-incision, sutureless cataract surgery with implantation of a PCIOL for senile cataract five years ago in the same eye. She had no ocular or systemic predisposing factors for wound dehiscence. Surgical exploration revealed a scleral rupture 7 mm in length, 2 mm behind the limbus at the 12’O clock position along the surgically-constructed wound. However, the scleral tunnel was not damaged. The PCIOL was removed. Wound closure was done to avoid infection of the intraocular structures. Her best-corrected visual acuity was 20/60 at the three months’ follow-up. Conclusion: Surgeons should be aware of such complications occurring due to trauma. We recommend suturing of the scleral wound to strengthen it in cases of a deep scleral groove or when there is a possibility of a premature entry of the wound into the anterior chamber. DOI: http://dx.doi.org/10.3126/nepjoph.v6i1.10777   Nepal J Ophthalmol 2014; 6 (2): 91-94

Long-Term Stability of Sutured Scleral Fixation of a Posterior Chamber Intraocular Lens With 10-0 Polypropylene for More Than 30 Years

2021 ◽  
pp. 247412642097887
Author(s):  
Gregg T. Kokame ◽  
Tarin T. Tanji ◽  
Jase N. Omizo
Keyword(s):  
Intraocular Lens ◽  
Posterior Chamber ◽  
Scleral Flap ◽  
Scleral Fixation ◽  
Polypropylene Suture ◽  
Long Term Stability ◽  
Posterior Chamber Intraocular Lens ◽  
Polypropylene Sutures

Purpose: We report the longest follow-up to our knowledge of stable scleral fixation of a posterior chamber intraocular lens (PC IOL) with 10-0 polypropylene sutures. Methods: A retrospective review is presented of a case with more than 30 years’ follow-up after performing sutured scleral fixation with 10-0 polypropylene suture using 2 sutures tied together under a scleral flap. One suture was a cow-hitch looped around the haptic, and the other suture was passed through the sclera to create the scleral fixation. Results: The scleral fixation with 10-0 polypropylene suture knots for both haptics of the PC IOL allowed central optic positioning with excellent vision for more than 30 years without suture breakage. Conclusions: Polypropylene sutures for scleral fixation of PC IOLs remained stable for more than 30 years with central positioning of the PC IOL, without exposure of the fixation suture knots through the conjunctiva, and without suture breakage.

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