Lensectomy with anterior vitrectomy plus goniosynechialysis followed by iris-claw intraocular-lens implantation in microspherophakia-induced glaucoma

被引:0
作者
Helmy, Hazem [1 ]
机构
[1] Res Inst Ophthalmol, Dept Glaucoma & Opt Nerve Dis, Glaucoma Unit, Rio, Egypt
关键词
anterior vitrectomy; iris-claw intraocular-lens; lensectomy; microspherophakia; ANGLE-CLOSURE GLAUCOMA; SPHEROPHAKIA; SECONDARY; MANAGEMENT; PHACOEMULSIFICATION; ABNORMALITIES; ASPIRATION; EXTRACTION; FEATURES; APHAKIA;
D O I
10.4103/ejos.ejos_51_21
中图分类号
R77 [眼科学];
学科分类号
100212 ;
摘要
PurposeThis study aims to investigate the effect of lensectomy with anterior vitrectomy plus goniosynechialysis followed by a secondary iris-claw intraocular-lens implantation on intraocular pressure (IOP) and visual acuity in pediatric patients with microspherophakia-associated angle-closure glaucoma.Patients and methodsA prospective randomized interventional case-series surgical study included 24 eyes of 12 patients aged from 6 to16 years with angle-closure glaucoma. Patients initially underwent lensectomy plus anterior vitrectomy and goniosynechialysis in a primary session followed later by secondary iris-claw implantation. The main outcome measure was IOP control and stability and the secondary outcome measure was visual acuity.ResultsIOP decreased from 25 & PLUSMN;2.59 mmHg preoperatively to 13.21 & PLUSMN;1.77, 14.71 & PLUSMN;2.33, 16.17 & PLUSMN;3.25, 16.13 & PLUSMN;3.55, 15.63 & PLUSMN;1.17, 15.67 & PLUSMN;1.17, 15.67 & PLUSMN;1.17, 15.71 & PLUSMN;1.23, 15.71 & PLUSMN;1.23, 5.71 & PLUSMN;1.23, 15.71 & PLUSMN;1.23, and 15.71 & PLUSMN;1.23 at 1, 3, 6, 12, 18, 24, 30, 36, 42, 48, 54, and 60 months postoperatively. IOP was controlled with complete success in 62.5% of cases and qualified success in 29.2%, while 8.3% became controlled with further glaucoma surgery. Anterior-chamber depth increased from 1.56 & PLUSMN;0.7 preoperatively to 3.33 & PLUSMN;0.20 postoperatively and remained stable over the next 5 years (P < 0.001). Visual acuity significantly improved from 0.79 & PLUSMN;0.1 to 0.88 & PLUSMN;0.8 (P < 0.001). Refractive error significantly decreased from -16 D preoperatively to -0.5 D postoperatively (P < 0.01). Antiglaucoma treatment decreased significantly as 62.55% of patients stopped receiving antiglaucoma treatment postoperatively (P < 0.001).ConclusionLensectomy with anterior vitrectomy and goniosynechialysis followed by secondary iris-claw intraocular-lens implantation is effective in the control of angle-closure glaucoma secondary to microspherophakia and results in significant improvement in visual acuity.
引用
收藏
页码:101 / 109
页数:9
相关论文
共 39 条
[1]   Unilateral lens extraction for high anisometropic myopia in children and adolescents [J].
Ali, Asim ;
Packwood, Eric ;
Lueder, Gregg ;
Tychsen, Lawrence .
JOURNAL OF AAPOS, 2007, 11 (02) :153-158
[2]   Chronic angle closure glaucoma secondary to frail zonular fibres and spherophakia [J].
Asaoka, R ;
Kato, M ;
Suami, M ;
Usami, Y ;
Hotta, Y ;
Sato, M .
ACTA OPHTHALMOLOGICA SCANDINAVICA, 2003, 81 (05) :533-535
[3]   Phacoemulsification in spherophakia with corneal touch [J].
Behndig, A .
JOURNAL OF CATARACT AND REFRACTIVE SURGERY, 2002, 28 (01) :189-191
[4]   Clear lens extraction and intraocular lens implantation in a case of microspherophakia with secondary angle closure glaucoma [J].
Bhattacharjee, Harsha ;
Bhattacharjee, Kasturi ;
Medhi, Jnanankar ;
DasGupta, Sushobhan .
INDIAN JOURNAL OF OPHTHALMOLOGY, 2010, 58 (01) :67-70
[5]   Long-term complications of iris-claw phakic intraocular lens implantation in Weill-Marchesani syndrome [J].
Burakgazi, AZ ;
Ozbek, Z ;
Rapuano, CJ ;
Rhee, DJ .
CORNEA, 2006, 25 (03) :361-363
[6]  
Chan Rufina Tin-Yan, 2002, Clin Exp Optom, V85, P294
[7]   Anterior axial lens subluxation, progressive myopia, and angle-closure glaucoma: Recognition and treatment of atypical presentation of ectopia lentis [J].
Dagi, Linda R. ;
Walton, David S. .
JOURNAL OF AAPOS, 2006, 10 (04) :345-350
[8]   LTBP2 null mutations in an autosomal recessive ocular syndrome with megalocornea, spherophakia, and secondary glaucoma [J].
Desir, Julie ;
Sznajer, Yves ;
Depasse, Fanny ;
Roulez, Francoise ;
Schrooyen, Marc ;
Meire, Francoise ;
Abramowicz, Marc .
EUROPEAN JOURNAL OF HUMAN GENETICS, 2010, 18 (07) :761-767
[9]   Spherophakia, nanophthalmia, hypoplastic ciliary body and glaucoma in brachydactyly-associated syndromes [J].
Dietlein, TS ;
Mietz, H ;
Jacobi, PC ;
Krieglstein, GK .
GRAEFES ARCHIVE FOR CLINICAL AND EXPERIMENTAL OPHTHALMOLOGY, 1996, 234 :S187-S192
[10]   Retropupillary iris-claw intraocular lens for the surgical correction of aphakia in cases with microspherophakia [J].
Fouda, Sameh Mosaad ;
Al Aswad, Mahmoud A. ;
Ibrahim, Basem M. ;
Bori, Ashraf ;
Mattout, Hala K. .
INDIAN JOURNAL OF OPHTHALMOLOGY, 2016, 64 (12) :884-887