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First Author: A.Ivashina RUSSIA
Co Author(s): N. Korshunova V. Neyasov M. Gulyaev V. Malyshev
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To evaluate the results of our tactics for treatment of glaucoma in Hyperopic eye.
Ophthalmic clinic OKOMED, Moscow, Russia
Clinical study included 77 eyes of 51 Hyperopic patients with glaucoma aged 58-84 years (mean age 69.2ḟ12.3). Hyperopia was from +1.25 to +11.25 D, with IOP (mean 31.0ḟ2.5 mm Hg), 4 eyes lost vision from glaucoma. Mean axial length was 20.9ḟ1.17 mm (18.61-22.9 mm), lens thickness was 4.68ḟ0.33 mm (4.1-5.8 mm).All patients received a medication for treatment of glaucoma in other clinics. Laser peripheral iridotomy (LPIT), Laser peripheral iridoplasty (LPIP) were performed in 18 eyes as first line of surgery. 46 eyes with initial cataract (high visual acuity) were operated by Phacoemulsification with Acrylic Lens implantation, Clear Lens Exchange was in 8 eyes. 23 eyes had combine operation Phacoemulsification and Noperforation deep sclerectomy. Axial eye length, lens thickness obtained by Echobiometry. Anterior segment biometric factors obtained by Optical Coherence Tomography (OptoVue, USA): anterior chamber angle (ACA), anterior chamber deep (ACD). Degree of optical neuropathy was evaluated by OCT of optical nerve.
10 patients with the medication had optical neuropathy with visual acuity from light to 0. Other eyes had significance loss of retinal ganglion cells. LPIT, LPIP were effective in widening of the angle and allows peripheral anterior chamber, decrease of IOP in 18 eyes. Phacoemulsification with IOL implantation in 54 eyes (in 18 eyes with LPIT, LPIP as first line of surgery) and combine operation (Phacoemulsification with IOL implantation and Noperforation deep sclerectomy) in 23 eyes was effective for decrease of IOP, receiving of potential visual acuity and correcting of Hyperopia. After operations we received ACD with 2.31ḟ0.37 to 3.42±0.45 mm, ACA with 9.54ḟ1,38Ḟ to 24.3ḟ5.4Ḟ, IOP with 31.0ḟ2.5 mm Hg to 18.6ḟ3.6 mm Hg. Mean BCVA-D became 0.75ḟ0.07.
Lens surgery is very efficacy for treatment of glaucoma in Hyperopic eye. Laser peripheral iridotomy and Laser peripheral iridoplasty are effective as first line of surgery. The medication of glaucoma in Hyperopic eye is not effective and direct to blindness.