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Phacoemulsification as a treatment option for chronic angle closure glaucoma: case report

Poster Details

First Author: M.Zemba ROMANIA

Co Author(s):    U. Ochinciuc   C. Papadatu   V. Enache   L. Sarbu   C. Avram  

Abstract Details



Purpose:

To present a case of a young Asian female patient, who underwent phacoemulsification with IOL implantation as a final treatment for her chronic angle closure glaucoma.

Setting:

Clinic of Ophtalmology, Emergency Clinic Central Military Hospital, Bucharest, Romania

Methods:

We present a 40 year old female patient who was referred to our clinic for other treatment possibilities concerning her resistanc to topical treatment for chronic angle closure glaucoma. She has been on the triple topical therapy for 2 years, which included beta-blocker, carboanhidraze inhibitor and pilocarpine. She has also 2 patents laser YAG ididotomies at both eyes, which was made after the second acute angle closure, which she suffered 3 months ago. To the examination the patient had a Best Corrected Visual Acuity(BCVA) of 20/20 both eyes; the IOP with the double therapy was 32 mmHg, on pilocarpine, was 18 mmHg,for the right eye and 12 mmHg for the left eye. Biomicroscopy showed shallow anterior chamber and the lens without clinical changes. Both eyes fundus: optic disc with vertical elongation of the cap, with localized thinning of inferior temporal neural retinal rin, the cap-disc ration 0.7 right eye, 0.8 left eye, nasal displacement of vessels. Anterior segment OCT showed shallow anterior chambers and a thick periferial iris stroma roll. We have decided to do phacoemulsification with hydrophobic acrylic IOL implantation in right eye. Intraoperative and postoperative treatment regimen were the same as if it was a regular cataract surgery.

Results:

In first postoperative day the patient's IOP was 15 mmHg on the right eye without any topical anti glaucoma therapy. One week postoperatively, the IOP dropped to 12 mmHg for the right eye, also without any anti glaucoma therapy and it has been stable for the past 4 months with insignificant fluctuations.

Conclusions:

Phacoemulsification can be considered as a treatment option for the patients with chronic angle closure glaucoma with or without cataract, especially for those patients with non-pupil block mechanisms of angle-closure glaucoma. More detailed prospective study on the large sample is needed to support this assertion. FINANCIAL INTEREST: NONE FINANCIAL INTEREST: NONE

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