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First Author: BojanKozomara BOSNIA AND HERZEGOVINA
Co Author(s): Maja Bohac Ernesta Potkonjak Nikica Gabric
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It is well known that in modern ophthalmology surgical treatment techniques are becoming more popular over the topical treatments for chronic angle closure glaucoma. Phacoemulsification is one of the most popular ones. The purpose is to present a case of a female patient who underwent phacoemulsification with IOL implantation as a final treatment for her chronic angle closure glaucoma.
: Eye Clinic “Svjetlost” Banja Luka, Bosnia-Herzegovina.
A 72 year old female patient was referred to our clinic for other treatment possibilities concerning her resistance and intolerance to topical treatment for chronic angle closure glaucoma which developed 32 years ago. She has been complaining of dry eye, chronic eye allergies and constant redness of the conjunctiva. She has been on the triple topical therapy for 2 years, which included beta-blocker, carboanhidraze inhibitor and latanoprost. She has also been using a few different artificial tear products which were unsuccessful in improving her symptoms. The BSCVA was 0.7 (Snellen) for the right eye and 0.8 (Snellen) for the left eye; the IOP with the triple therapy was 27 mmHg for the right eye and 29 mmHg for the left eye. Biomicroscopy showed significant bilateral conjunctival allergic hyperemia, band keratopathy, shallow anterior chamber and incipient cortical cataracts. Anterior segment OCT showed shallow anterior chambers, large nucleus with cortical blurring, while the posterior segment OCT gave better insight in the glaucomatous changes of right optical nerve. We have decided to do same day bilateral phacoemulsification with 3-peace hydrophobic acrylic IOL implantation in both eyes. Intraoperative and postoperative treatment regimen were the same as if it was a regular cataract surgery.
At first postoperative day patient’s IOP was 24 mmHg on the right eye and 25 mmHg on the left eye without any topical anti glaucoma therapy. One week postoperatively, the IOP dropped to 15 mmHg for the right eye and 16 mmHg for the left eye, also without any anti glaucoma therapy and it has been stable for the past 8 months with insignificant fluctuations.
Phacoemulsification can be considered as a treatment option for the patients with chronic angle closure glaucoma with or without cataract, especially for those patients for whom the topical therapy is not an option. More detailed prospective study on the large sample is needed to support this assertion. FINANCIAL INTEREST: NONE