Chronic Angle-Closure Glaucoma Associated With Nanophthalmos : Management Issues

Published 2024 - 42nd Congress of the ESCRS

Reference: PO056 | Type: Case Report | DOI: 10.82333/478q-fy22

Authors: Monia CHEOUR* ¹ , Molka FERCHICHI ¹ , Meriem OUEDERNI ¹ , Rym MAAMOURI ¹

¹Ophthalmology,Habib Thameur hospital ,Tunis,Tunisia

Purpose

This case report aims to discuss the management of a patient with bilateral nanophthalmos presenting with chronic angle closure glaucoma (CACG).

Setting

Department of Ophthalmology, Habib Thameur Hospital, Tunis, Tunisia.

Report of case

A 71-year-old patient presented with complaints of chronic visual blurring in his right eye (RE). He was diagnosed with advanced glaucoma in both eyes. His refraction was +15.00D in both eyes. His best corrected visual acuity was limited to light perception without projection in his RE and 20/100 in his LE. The intraocular pressure was 54 mmHg in RE and 12 mmHg in LE. Slit-lamp examination revealed a clear cornea, shallow anterior chamber, and nuclear cataract in both eyes. Non-dilated funduscopy showed a cup/disc ratio of 1 in RE and 0.9 in LE. Ultrasound biomicroscopy revealed an anterior chamber depth of 1.27 mm in RE and 1.59 mm in LE, a lens vault of 1.66 mm in RE and 1.48 mm in LE, with a closed iridocorneal angle in RE and a very narrow angle in LE. Axial lengths were significantly short, measuring 16.58 mm in RE and 16.49 mm in LE, consistent with nanophthalmos. B-scan ultrasound demonstrated significant sclerochoroidal thickening. Our decision was to perform cataract surgery combined with sclerostomy.

Conclusion/Take home message

This case highlights the complexity of managing CACG in a patient with nanophthalmos. the short axial length, the narrowness of the anterior chamber and the sclerochoroidal thickening make surgery more difficult and complications more frequent. It is believed that cataract surgery combined with sclerostomy should lead to satisfactory results.