To Describe A Clinical Case Of Acute Angle-Closure Glaucoma And Its Therapeutic Management.
Published 2025 - 43rd Congress of the ESCRS
Reference: PPE.06 | Type: ESONT Abstract | DOI: 10.82333/0gca-na90
Authors: José Maria Sánchez Pina 1 , Carmen Sánchez Sánchez* 1 , Ester Villar Arrondo 1 , Patricia Gonzalez Rodriguez 1
1CLINICA REMENTERIA,Madrid,Spain
Purpose
To describe a clinical case of acute angle-closure glaucoma and its therapeutic management.
Setting
CLINICA REMENTERIA , MADRID
Methods
Male patient , 58 years old, with hyperemia and blurred vision since one month. Visual acuity (VA) was 0.3 and 1.0 in right and left eye respectively.
He presented bilateral pancorneal oedema with diffuse microbullae and intraocular pressure (IOP) of 62 mmHg in both eyes.
Maximum topical and oral medical treatment was started.
The following day the IOP decreased and diagnostic tests such as gonioscopy, perimetry, optical coherence tomography of the nerve fibre layer and of the anterior pole were performed. A diagnosis of phacomorphic glaucoma with a 360º closed angle was made and cataract surgery was proposed in OU by blocking the trabecular meshwork, associating microsurgery with iStent Inject W implant if possible.
Results
The combined surgery was performed without incident. At 24 hours post-surgery the IOP was 13 mmHg and 12 mmHg; and after 18 months of follow-up the uncorrected vision visual acuity was 1.0 in both eyes with excellent IOP control (11 mm Hg) without treatment, maintaining stable perimetry, optic nerve and retinal fiber layer Ocular coherence tomography in both eyes.
Conclusions
Trabecular microsurgery with iStent inject associated with phacoemulsification in phacomorphic glaucoma is an effective technique due to its coadjuvant effect on decreasing intraocular pressure in a trabecular meshwork previously compromised and with a reduction in its functionality.