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Phacoemulsification in patients with previously treated angle-closed glaucoma

Poster Details

First Author: V.Dzinic SERBIA

Co Author(s):    M. Dzinic   N. Babic                 

Abstract Details

Purpose:

To show the surgical technique of phacoemulsification in the series of patients who were previously treated for angular glaucoma either with surgical iridectomy or YAG-laser iridotomy.

Setting:

Clinical center of Vojvodine, University Eye clinic, Novi Sad, Serbia Eye center Dzinic

Methods:

In 22 eyes cataract surgery was performed. Visual acuity range was from light perception to 0,6 (Snellen charts). In all patients limited mydriasis was observed and shallow anterior chamber. After trypan blue capsule dying, manual mydriasis was conducted either by stretching of the iris, visco-mydriasis or placement of the iris hooks. In patients with “intumescent” cataract aspiration of liquefied cortical material was performed. Anterior chamber is then refilled with depressive viscoelastic and in all patients coaxial 2.75 mm phacoemulsification technique was performed with temporal approach and in the bag implantation of hydrophilic. Follow up periods was 24 months.

Results:

In all patients successful cataract removal was achieved. No capsular rupture was observed. In all patients corneal oedema was resolved at the follow-up visit 3 weeks after the surgery. Best corrected visual acuity in all patients ranges from 0.5 to 1.0 depending from the optical nerve damage. All patients remain stable during follow-up period.

Conclusions:

Previously surgical procedures (iridectomy or iridotomy) in patients with angular glaucoma usually lead to accumulation of inflammatory materials. Posterior synechia can be found on pupillary margin or on the whole posterior surface of the iris and can impair adequate mydriasis. This study shows that usage of one of pupil stretching technique or devices are absolute necessities in order to achieve adequate mydriasis. Dispersive viscoelastic are helping in corneal protection due to shallower anterior chamber in those group of patients and aspiration of liquefied cortical materials lead to better control of the capsulorexis in patients with white intumescent cataract.

Financial Disclosure:

NONE

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