Extracapsular cataract extraction with posterior chamber lens implantation in primary angle-closure glaucoma.
OBJECTIVE
To evaluate long-term intraocular pressure (IOP) control after extracapsular cataract extraction (ECCE) with posterior chamber intraocular lens (IOL) implantation in patients with primary angle-closure glaucoma.


METHODS
Ophthalmology Department, Groote Schuur Hospital, Cape Town, South Africa.


METHODS
This retrospective study comprised 17 patients (19 eyes) with primary angle-closure glaucoma who had ECCE and posterior chamber IOL implantation. Four presented initially with acute glaucoma, 5 with subacute angle-closure glaucoma, and 8 (10 eyes) with chronic angle-closure glaucoma. In all, less than half the circumference of the angle was permanently closed. The drainage angle was evaluated preoperatively and postoperatively to monitor changes in the amount of angle closure. Intraocular pressure was measured in the early and late postoperative periods.


RESULTS
On the first postoperative day, mean IOP was 17.2 mm Hg, although 5 patients (26%) had an IOP rise above 21 mm Hg despite the use of perioperative topical pilocarpine gel. After a mean follow-up of 19 months, IOP remained below 22 mm Hg without medication in 13 eyes (68%) and with topical medication in 5 eyes (26%). Mean number of glaucoma medications was reduced from 1.5/eye preoperatively to 0.5/eye postoperatively.


CONCLUSIONS
Cataract extraction with IOL implantation resulted in good long-term IOP control in patients with primary angle-closure glaucoma, suggesting that combined cataract and trabeculectomy surgery may not be necessary to achieve long-term IOP control in these patients.
Acton
J
J
Department of Ophthalmology, Groote Schuur Hospital and University of Cape Town, South Africa.
Salmon
J F
JF
Scholtz
R
R
D000287:Administration, Topical; D000319:Adrenergic beta-Antagonists / Q000008:administration & dosage / Q000627:therapeutic use; D000368:Aged; D000369:Aged, 80 and over; D002386:Cataract / Q000150:complications*; D002387:Cataract Extraction / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D015812:Glaucoma, Angle-Closure / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D006801:Humans; D007429:Intraocular Pressure / Q000187:drug effects; D007910:Lenses, Intraocular; D002040:Levobunolol / Q000008:administration & dosage / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D009883:Ophthalmic Solutions; D012189:Retrospective Studies
D000319:Adrenergic beta-Antagonists; D009883:Ophthalmic Solutions; D002040:Levobunolol