Therapeutic Efficacy of Phacoemulsification and Intraocular Lens Implantation in Phacomorphic Glaucoma

ABSTRACT

PURPOSE: To evaluate the therapeutic efficacy of phacoemulsification in treating phacomorphic glaucoma. METHODS: We observed 25 eyes of 25 patients who had undergone phacoemulsification and intraocular lens implantation for the treatment of phacomorphic glaucoma. Intraocular pressure (IOP), best corrected visual acuity (BCVA), depth of anterior chamber, management and complications between preoperative and postoperative periods were analyzed retrospectively. RESULTS: The mean IOP was 49.0 +/- 10.6 mmHg (range 31~70 mmHg) before the operation and 13.2 +/- 2.8 mmHg (range 8~20 mmHg) at 36 months after surgery (Paired T-test, p<0.0001). We could not find any case with increased IOP in our series for more than 3 years. The postoperative IOP decreased significantly the day after surgery (Paired T-test, p<0.0001). Improvement of postoperative visual acuity was remarkable from the first week after operation (Paired T-test, p<0.0001). Postoperatively, the visual acuity was improved except for one eye with preoperative visual acuity of no light perception. Especially, BCVA in 15 cases (60%) was above 20/40. Preoperatively, the anterior chambers were extremely shallow (average 1.5 +/- 0.3 mm) by the swollen lens, and the average postoperative anterior chamber depth increased significantly by 2.6 +/- 0.1 mm on A-scan. The ratio of lens thickness to axial length factor was 2.5 +/- 0.1, indicating the shallow anterior chamber. Continuous postoperative medical treatment for IOP control was needed in one case, where peripheral anterior synechiae were observed by gonioscopy immediately after surgery. CONCLUSIONS: Phacoemulsification is a very safe and effective procedure for the treatment of phacomorphic glaucoma.