Cataract Surgery In Patients With Pigmentary Glaucoma

To assess the hypotensive effect of cataract phacomulsification in patients with pigmentary glaucoma

Department of Ophthalmology, Kharkiv National Medical University, Ophthalmic Diagnostics Center “ZIR”, Kharkiv, Ukraine

The study enrolled 7 patients (11 eyes). The existence of iris concavity was demonstrated in all patients. They are having phacoemulsification with intraocular lens (IOL) implantation and a diagnosis of pigmentary glaucoma. Data about UBM parameters, IOP values and number of glaucoma medications used was collected at baseline, 1, 3, 6 and 12mo postoperatively.

After phacoemulsification, there was a statistically significant reduction in IOP values and glaucoma medications use compared to baseline: a 28% decrease in IOP values was evidenced, and a 56.8% reduction in the number of medications used at the one-year follow-up.

Thus, not only the refractive error (high myopia) was corrected in patients, but also a hypotensive effect was obtained. The latter is explained by the elimination of contact between the iris and the lens with the ligamentous apparatus. Irrigation and aspiration during cataract surgery, followed by "washing out" of the pigment from the trabecular meshwork.

In our patients, lens extraction rectifies the iris concavity present in pigmentary glaucoma, reducing the IOP and the number of drugs needed for its control. Like cataract operation in normal individuals, cataract operation can lead to improved visual functioning and quality of life in glaucoma patients.