ABSTRACT
@#AIM: To evaluate the clinical efficiency of phacoemulsification combined with intrascleral fixation of intraocular lens(IOL)by using Yamane's technique in the treatment of acute secondary angle-closure(ASAC)caused by lens subluxation.<p>METHODS: Clinical data of 15 patients(15 eyes)with ASAC caused by lens subluxation who underwent phacoemulsification combined with intrascleral fixation of IOL by using Yamane's technique from June 2019 to December 2020 were reviewed retrospectively. The patients were followed for 3mo. The preoperative and postoperative intraocular pressure(IOP), best corrected visual acuity(BCVA), positions of the IOL and complications were observed. <p>RESULTS: All the operations were successfully completed. The postoperative IOPs were lower than preoperative IOPs. There were overall differences between preoperative and postoperative IOPs(F=165.57, P<0.001). Through further pairwise comparison, the IOPs at 1d, 1wk, 1, and 3mo after operation were significantly different from IOPs before operation(all P<0.001). The IOPs remained normal range at 1wk, 1, and 3mo after operation. The BCVA at 3mo after operation was significantly better than the preoperative BCVA(t=10.717, P<0.001). All IOLs were in the expected position without an obvious tilt or displacement. No serious complications occurred after the operation. <p>CONCLUSION: The surgical strategy of phacoemulsification combined with intrascleral fixation of IOL by using Yamane's technique in the treatment of ASAC caused by lens subluxation was safe and effective by lowing IOP, rescuing visual, maintaining stability of IOL and reducing complications.
ABSTRACT
A 36-year-old female presented with the complaints of pain, photophobia, redness, and sudden diminution of vision in both the eyes following topiramate for migraine treatment. On examination, there was panuveitis with angle-closure glaucoma in both the eyes with fibrinous exudate with pigments in the anterior chamber of the left eye. B scan revealed increased choroidal thickness in both the eyes. Serial anterior segment optical coherence tomography scans were done in the left eye to demonstrate the gradual resolution of the fibrin material from the anterior chamber. There was complete resolution of inflammation in both eyes following discontinuation of topiramate and treatment with systemic and topical steroids. There was an improvement in visual acuity in the left eye following complicated cataract surgery.
ABSTRACT
Drug-induced secondary angle closure is quite common and in the majority of cases simply stopping the medication leads to rapid reversal of the condition and resolution of glaucoma. We describe here a patient who presented with secondary angle closure glaucoma and myopia following mefenamic acid ingestion which was managed successfully by stopping the medication, symptomatic treatment and reassurance.
Subject(s)
Adult , Anti-Inflammatory Agents, Non-Steroidal/adverse effects , Anti-Inflammatory Agents, Non-Steroidal/therapeutic use , Choroid/diagnostic imaging , Choroid Diseases/chemically induced , Choroid Diseases/diagnosis , Diagnosis, Differential , Glaucoma, Angle-Closure/chemically induced , Glaucoma, Angle-Closure/diagnosis , Gonioscopy , Headache/drug therapy , Humans , Intraocular Pressure , Male , Mefenamic Acid/adverse effects , Mefenamic Acid/therapeutic use , Myopia/chemically induced , Myopia/diagnosis , Refraction, OcularABSTRACT
PURPOSE: To evaluate the effect on the intraocular pressure after the phacoemulsification on the secondary angle-closure glaucoma associated with lens subluxation. METHODS: We reviewed the clinical records of 8 patients (9 eyes) prospectively who's intraocular pressure (IOP) didn't controlled with medication, so received the lens removal by the phacoemulsification. We reviewed their intraocular pressure, visual acuity, and complications before and after the surgery. RESULTS: The patients' mean age was 60.4 +/- 11.9. Initial mean IOP was 41.2 +/- 15.0 mmHg with mean of 1.1 +/- 1.8 medication and mean preoperative IOP was 30.4 +/- 11.2 mmHg with mean of 1.2 +/- 1.1 medication. Postoperative IOP was 16.2 +/- 2.8 mmHg with usage of 0.6 +/- 0.9 medication during the follow-up of 4.6 +/- 1.4 months, and the IOP of 6 eyes (66.7%) were controlled under 21 mmHg without any medication. With anti-glaumatic medication, the IOP of all patients were controlled under 21 mmHg. The best corrected visions were also improved after the surgery in all patients. The complications occurred in 5 eyes (55.6%), temporarily increased IOP in 4 eyes (44.4%), and hyphema in 1 eye (11.1%). CONCLUSIONS: The phacoemulsification in the secondary angle-closure glaucoma with the lens subluxation showed relatively satisfactory results, but thorough follow-up would be needed due to the recurrence of elevated IOP afterward.