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Evaluation of efficacy of lens extraction for intraocular pressure reduction in eyes with primary angle closure glaucoma and primary angle closure

Poster Details

First Author: A.Wilkos-Kuc POLAND

Co Author(s):    A. Rozegnal-Madej   A. Wlaz   T. Zarnowski        

Abstract Details



Purpose:

The aim of this study was to evaluate the intraocular pressure (IOP) lowering effect of the lens removal in eyes with primary angle closure glaucoma (PACG) and primary angle closure (PAC).

Setting:

Department of Diagnostics and Microsurgery of Glaucoma, Medical University, Lublin, Poland

Methods:

Retrospective analysis of 114 eyes of 97 patients (84 women, 13 men; mean age 70.1 years) with PACG and PAC treated with lens extraction. Outcome measures: age, gender, visual acuity, IOP reduction over time, preoperative and postoperative number of IOP-lowering medications, axial length, intraocular lens (IOL) power, requirement for additional antiglaucoma operations, complications. Patients were divided into three groups: 1. Patients with PAC (lens extraction up to 60 days from acute angle closure (AAC); 22 eyes) 2. Patients with PACG with a history of previous AAC (documented AAC over 60 days, mean 61.1 months prior to lens removal; 39 eyes) 3. Patients with PACG without a history of previous AAC (53 eyes)

Results:

1. In the group with PAC mean IOP was reduced from 42.2 ± 15.4 mmHg (mean ± SD) under 2.6 IOP-lowering medications to 20.2 ± 10.4 mmHg under 1.1 IOP-lowering medications (mean IOP reduction 52.1%) in mean follow-up of 12.2 months. In 21 eyes (95.5%) IOP was reduced, in 1 eye (4.5%) IOP increased. 2. In the group with PACG with a history of previous AAC mean IOP was reduced from 29.0 ± 15.7 mmHg under 2.1 IOP-lowering medications to 17.0 ± 7.5 mmHg under 0.7 IOP-lowering medications (mean IOP reduction 41.3%) in mean follow-up of 15.4 months. In 32 eyes (82.1%) IOP was reduced, in 4 eyes (10.2%) IOP did not change, in 3 eyes (7.7%) IOP increased. 3. In the group with PACG without a history of previous AAC mean IOP was reduced from 22.8 ± 8.0 mmHg under 1.75 IOP-lowering medications to 18.8 ± 7.4 mmHg under 1.5 IOP-lowering medications (mean IOP reduction 17.5%) in mean follow-up of 13.5 months. IOP was reduced in 35 eyes (66%), in 4 eyes (7.5%) IOP did not change, in 14 eyes (26.5%) IOP increased.

Conclusions:

1. Lens extraction in eyes with PACG and PAC resulted in significant IOP reduction in all groups. 2. The biggest IOP reduction was achieved in the group with PAC, where lens extraction was performed up to 60 days from AAC. FINANCIAL INTEREST: NONE

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