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Our experience in surgery treatment of hypermature cataract complicated with phacolytic glaucoma

Poster Details


First Author: B.Milojko Scepovic MONTENEGRO

Co Author(s): A. Adzic Zecevic   D. Djurovic Raonic                 

Abstract Details

PURPOSE:Purpose:

The aim of this case study is to explane the results of the surgery of phacolytic glaucoma treated by phacoemulsification and trabeculectomy , both separately and at the same time.

Setting:

Ophthalmology clinic, Clinicl center of Montenegro, Podgorica, Montenegro

Methods:

Observations were done on 6 patients with different picture of phacolytic glaucoma treated at our Clinic from 2015. to 2017. The group consisted of 2 females and 4 males, with their age ranging from 62 to 83. Phacoemulsification was performed and intraocular lens was implanted too on each of the patienst. In 2 cases we also did trabeculectomy 2 days afterwords , in 4 cases we combined phacoemulsification and trabeculectomy simultaniousely.. Visual acuity and intraocular pressure were assessed both before and after the operation, possible complications are described in this paper.

Results:

Before the operation visual acuity were: irregular light perception in 2 cases, regular light perception in 4 cases. Intraocular pressure readings were 35 mmHg to 75 mmHg. In 5 cases before the operation we had performed paracentesis, due to non-effective local and systemic hypotensive therapy. In 2 cases we made phacoemulsification solely, but after 2-3 days we had increase of IOP more than 30 mm Hg, which can be explained by obstruction of trabecular meshwork by lens proteins, phagocytizing macrophages, and other inflammatory debris. It was necessary to perform trabeculectomy. In 4 cases we opted for combined surgery methods of phacoemulsification and trabeculectomy. In those 4 cases less kerahthopaty was noted and cornea was more transparent as well. Postoperative visual acuity was less than 5/50 in 2 cases, 0,2 – 0,4 in 3 cases, and 0,6 in one case. Intraocular pressure was lowered with all the patients, with typical value of 15.5 mm Hg, and the pain disappeared.

Conclusions:

Phacoemulsification and intraocular lens implantation showed as not good enough method to treat hyper mature cataract with phacolytic glaucoma, mainly because of occlusion of trabecular meshwork caused by lens proteins. A better method proved to be to combine phacoemulsification and trabeculectomy surgery , keeping in mind that in order to obtain satisfactory results this ought to be done as quickly as possible after increase of intraocular pressure as the core symptom is spotted. Additional benefit resulting out of this approach was a steady decrease in intraocular pressure readings.

Financial Disclosure:

None

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