RESUMEN
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.
Asunto(s)
Adulto , Antiinflamatorios no Esteroideos/efectos adversos , Antiinflamatorios no Esteroideos/uso terapéutico , Coroides/diagnóstico por imagen , Enfermedades de la Coroides/inducido químicamente , Enfermedades de la Coroides/diagnóstico , Diagnóstico Diferencial , Glaucoma de Ángulo Cerrado/inducido químicamente , Glaucoma de Ángulo Cerrado/diagnóstico , Gonioscopía , Cefalea/tratamiento farmacológico , Humanos , Presión Intraocular , Masculino , Ácido Mefenámico/efectos adversos , Ácido Mefenámico/uso terapéutico , Miopía/inducido químicamente , Miopía/diagnóstico , Refracción OcularRESUMEN
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.