Vitrectomy for phacolytic glaucoma in a patient with homocystinuria.
OBJECTIVE
To determine the successful treatment of unilateral phacolytic glaucoma by vitrectomy and trabeculectomy in a patient with homocystinuria whose lens had dislocated into the vitreous at least 15 years earlier.


METHODS
In a 32-year-old woman with homocystinuria, bilateral dislocation of the lens into the vitreous, and phacolytic glaucoma in her left eye a three-port pars plana vitrectomy was performed with the patient under general anesthesia. The lens was removed and a trabeculectomy fashioned. Special precautions for general anesthesia included preoperative aspirin and compression stockings for thromboembolic prophylaxis and intraoperative dextrose infusion, 5%, to maintain intravascular volume and prevent hypoglycemia.


RESULTS
The intraocular pressure and uveitis resolved postoperatively with improvement in the visual acuity and intraocular pressure, which returned to normal without further treatment.


CONCLUSIONS
Phacolytic glaucoma is best resolved by removal of the exciting lens material. Pars plana vitrectomy with the patient under general anesthesia can be carried out safely despite the risks traditionally associated with homocystinuria.
Smith
G T
GT
The Sussex Eye Hospital, Brighton, England.
Vakalis
A N
AN
Brittain
G P
GP
Casswell
A G
AG
D000328:Adult; D005260:Female; D005901:Glaucoma / Q000209:etiology / Q000601:surgery*; D006712:Homocystinuria / Q000150:complications*; D006801:Humans; D007429:Intraocular Pressure; D007906:Lens Subluxation / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D014463:Ultrasonography; D014792:Visual Acuity; D014821:Vitrectomy