Management Of Ice Syndrome Patients With Glaucoma- A Retrospective Analysis.

0utcome of intraocular pressure (IOP) control in patients of Irido-Corneal Endothelial (ICE) syndrome with glaucoma

Advanced Eye Centre, Postgraduate Institute of Medical Education and Research, Chandigarh, India- A Tertiary Care Centre

Glaucoma is a frequent association with ICE syndrome.  Managing glaucoma in these patients is a challenge. Medical records of 22 eyes of 22 patients with ICE syndrome presenting to Glaucoma Clinic of a tertiary eye centre between 2003 - 2013 were retrieved.  Demographic data included visual acuity (VA),  IOP, clinical findings, treatment and outcome at last follow-up (FU). Main outcome measures were IOP control, VA and medication required.

22 patients of ICE Syndrome,  with mean age 44.55±11.77 years. . 8 patients of Medical management (36.37%) with baseline IOP of 16.71±8.75 mmhg on 1.00±1.00 drugs with mean FU of 41.57±31.91 months maintained IOP of 16.57±3.6mmhg on 1.29±1.11 drugs. 14 patient underwent  surgery: 8  trabeculectomy, 6 GDD. In Trabeculectomy group, IOP reduced from 22.43±7.44mmHg on 3.29±0.94 anti-glaucoma medications to 13.29±4.71mmHg on 0.43±0.79 medications at last FU. Two eyes  required bleb revision. In GDD group, IOP reduced from 32.33±13.59mmHg on 3.17±0.75 anti-glaucoma medications to 15.67±6.25mmHg on 0.83±0.75 medications at last FU. Two eyes underwent cyclophotocoagulation for refractory glaucoma. Mean number of surgeries required was 1.5 .

Glaucoma associated with ICE syndrome requires predominantly surgical management and although successful, multiple procedures are often required.