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Objective:To evaluate the efficacy and safety of limited pars plana vitrectomy(LPPV), pressure-controlled phacoemulsification(PCP), intraocular lens implantation(IOL), and posterior capsulotomy (PC) in treatment of nanophthalmic glaucoma eyes which intraocular pressure(IOP) were still out of control after peripheral iridectomy.Methods:All 24 patients(29 eyes) with nanophthalmic glaucoma whose IOP failed to be reduced after peripheral iridectomy and needed LPPV plus PCP plus IOL plus PC were recruited from July 2017 to April 2021. The age of these patients was(44.6±11.0) years old. Preoperative and postoperative IOP, best corrected visual acuity(BCVA), anterior chamber depth(ACD) and number of glaucoma medications were recorded by chart review and compared by using paired t-test or Wilcoxon signed rank-sum test. P<0.05 was considered as statistical significant. IOP could be controlled in normal range(≥5 mmHg and≤21 mmHg), without both of disease progression and serious complications were regarded as the success criteria of the operation. Surgical success rate was evaluated. Surgery-associated complications were recorded. Results:The average follow-up time was(11.52±12.44) months. After the microsurgery, IOP decreased from(33.12±9.25) mmHg to(14.23±3.44) mmHg( P<0.01); The ACD increased from(1.23±0.46) mm to(2.86±0.62) mm, and the median number of glaucoma medications dropped from 3(3,4) to 3(0,3) at final follow-up visit( P<0.05). There were no significant differences in BCVA( P=0.196) and the degrees of angle closure(AC) ( P=0.478) before and after operation. The total surgical success rate was 86.2%(25/29) at the final follow-up visit. Two eyes suffered from local choroidal detachment which recovered within 2 weeks with medical treatment. Conclusion:LPPV plus PCP plus IOL plus PC is a safe and effective novel surgical procedure in the treatment of nanophthalmic glaucoma patients with uncontrolled IOP after peripheral iridectomy. It could significantly decrease IOP, increase the depth of ACD, reduce the number of glaucoma medications and maintain BCVA. It can be considered as a first choice for the surgical management for patients with a such condition.
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Objective@#To quantitatively measure biological parameters of nanophthalmos and analyze the correlation between axial length (AL) and the other biological parameters.@*Methods@#The clinical data of 71 eyes of 43 patients identified with nanophthalmos (AL≤20 mm) from September 2012 to August 2018 in Zhongshan Ophthalmic Center were retrospectively analyzed.All enrolled patients underwent ophthalmological examinations including best-corrected visual acuity, refraction, slit-lamp biomicroscopy, fundus examination, Goldmann applanation tonometry, A-scan ultrasound examinations, ultrasound biomicroscopy, spectral domain optical coherence tomography (SD-OCT) and nonmydriatic fundus photography.Pearson correlation analysis was used to analyze the relationship between AL and all biological parameters.This study followed the Declaration of Helsinki and was approved by the Ethics Committee of Zhongshan Ophthalmic Center (NO.2017KYPJ092). All patients signed informed consent.@*Results@#Of the 43 patients, the average age was (46.00±12.75) years, the mean intraocular pressure was (24.97±14.87)mmHg (1 mmHg=0.133 kPa). The mean best corrected visual acuity was 1.14±0.79, the mean refraction was (11.61±4.09)D.The mean AL, central corneal thickness (CCT), central anterior chamber depth(ACD), anterior chamber width (ACW), len thickness(LT) and vitreous cavity length(VCL) was (17.13±1.57)mm, (550±60)μm, (1.64±0.37)mm, (11.17±0.61)mm, (5.01±0.51)mm and (10.10±1.80)mm, respectively.The average retinal nerve fiber layer thickness (mRNFLT), macular foveal retinal thickness (FRT) and subfoveal choroidal thickness (SFCT) was (98.51±40.93), (294.46±116.83) and (488.72±133.06)μm, respectively.The ratio of ACD to AL, LT to AL, and VCL to AL was 9.6%, 29.4% and 59.3%, respectively.The ACW and VCL were positively correlated with AL(r=0.432, 0.978; both at P<0.001); whereas, LT and FRT were negatively correlated with AL(r=-0.272, P=0.027; r=-0.679, P<0.001). There was no correlation between CCT, central ACD, mRNFLT, SFCT and AL (r=0.153, -0.053, -0.322, 0.063; all at P>0.05).@*Conclusions@#Nanophthalmos has the characteristics of narrow anterior and posterior segment structure.The ratio of LT to AL is increased and the ratio of VCL to AL is decreased.The AL is positively correlated with ACW and VCL, negatively correlated with LT and FRT.
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Objective To quantitatively measure biological parameters of nanophthalmos and analyze the correlation between axial length ( AL) and the other biological parameters. Methods The clinical data of 71 eyes of 43 patients identified with nanophthalmos ( AL≤20 mm ) from September 2012 to August 2018 in Zhongshan Ophthalmic Center were retrospectively analyzed. All enrolled patients underwent ophthalmological examinations including best-corrected visual acuity,refraction,slit-lamp biomicroscopy,fundus examination,Goldmann applanation tonometry,A-scan ultrasound examinations, ultrasound biomicroscopy, spectral domain optical coherence tomography ( SD-OCT) and nonmydriatic fundus photography. Pearson correlation analysis was used to analyze the relationship between AL and all biological parameters. This study followed the Declaration of Helsinki and was approved by the Ethics Committee of Zhongshan Ophthalmic Center (NO. 2017KYPJ092). All patients signed informed consent. Results Of the 43 patients,the average age was (46. 00±12. 75) years,the mean intraocular pressure was (24. 97± 14. 87)mmHg (1 mmHg=0. 133 kPa). The mean best corrected visual acuity was 1. 14±0. 79,the mean refraction was (11.61±4.09)D. The mean AL,central corneal thickness (CCT),central anterior chamber depth(ACD), anterior chamber width (ACW),len thickness(LT) and vitreous cavity length(VCL) was (17. 13±1. 57)mm,(550± 60)μm,(1. 64±0. 37)mm,(11. 17±0. 61)mm,(5. 01±0. 51)mm and (10. 10±1. 80)mm,respectively. The average retinal nerve fiber layer thickness ( mRNFLT ) , macular foveal retinal thickness ( FRT ) and subfoveal choroidal thickness (SFCT) was (98. 51±40. 93),(294. 46±116. 83) and (488. 72±133. 06)μm,respectively. The ratio of ACD to AL, LT to AL, and VCL to AL was 9. 6％, 29. 4％ and 59. 3％, respectively. The ACW and VCL were positively correlated with AL(r=0. 432,0. 978;both at P<0. 001);whereas,LT and FRT were negatively correlated with AL(r=-0. 272,P=0. 027;r=-0. 679,P<0. 001). There was no correlation between CCT,central ACD, mRNFLT,SFCT and AL (r=0. 153,-0. 053,-0. 322,0. 063;all at P>0. 05). Conclusions Nanophthalmos has the characteristics of narrow anterior and posterior segment structure. The ratio of LT to AL is increased and the ratio of VCL to AL is decreased. The AL is positively correlated with ACW and VCL,negatively correlated with LT and FRT.