Résumé
Glaucoma and cataracts are the leading causes of blindness, and surgery is an important treatment option. Patients with glaucoma have clinical characteristics such as high intraocular pressure, shallow anterior chamber and short axial length, and the ocular structure is often altered after anti-glaucoma surgery like trabeculectomy. These changes also lead to differences in the accuracy of intraocular lens(IOL)refractive calculation between cataract surgery after anti-glaucoma surgery or combined glaucoma and cataract surgery and alone cataract surgery. Meanwhile glaucoma patients' individual clinical characteristics and structural changes caused by anti-glaucoma surgery have shown differences in the impact on the predictive accuracy of IOL diopters and the type of refractive drift. This article reviews the latest research advances in the causes of refractive error(RE), the characteristics of refractive drift, and the selection of the most appropriate IOL formula for glaucoma patients undergoing cataract surgery or cataract surgery after anti-glaucoma surgery or combined glaucoma and cataract surgery.
Résumé
Glaucoma is a potentially blinding complication of uveitis.Management of uveitic glaucoma remains challenging.Vision can be partly recovered if correct diagnosis and timely treatment are given.The mechanisms of intraocular pressure (IOP) elevation include peripheral anterior synechia, pupillary block, trabecular meshwork inflammation, cyclitis and prolonged corticosteroid use.Treatment is targeted at identifying the cause of raised IOP first, followed by etiological treatment and IOP lowering medications.The indications for surgery include uncontrolled IOP despite maximum-tolerated medical management or definite optic nerve damage.Recently, selective laser trabeculopasty for steroid-induced intraocular hypertension/open angle glaucoma, CO2 laser-assisted sclerectomy surgery or micro-invasive glaucoma surgery for uveitic glaucoma have been gradually applied in clinical practice.
Résumé
Glaucoma is a potentially blinding complication of uveitis. Management of uveitic glaucoma remains challenging. Vision can be partly recovered if correct diagnosis and timely treatment are given. The mechanisms of intraocular pressure ( IOP) elevation include peripheral anterior synechia,pupillary block,trabecular meshwork inflammation, cyclitis and prolonged corticosteroid use. Treatment is targeted at identifying the cause of raised IOP first,followed by etiological treatment and IOP lowering medications. The indications for surgery include uncontrolled IOP despite maximum-tolerated medical management or definite optic nerve damage. Recently,selective laser trabeculopasty for steroid-induced intraocular hypertension/open angle glaucoma,CO2 laser-assisted sclerectomy surgery or micro-invasive glaucoma surgery for uveitic glaucoma have been gradually applied in clinical practice.