Phacoemulsification in filtered chronic angle closure glaucoma eyes.
OBJECTIVE
To report the results of phacoemulsification in eyes with chronic angle closure glaucoma having a functional filtering bleb.


METHODS
A prospective and non-comparative study was undertaken in 60 consecutive eyes of 44 patients having a functional filtering bleb for chronic angle closure glaucoma and undergoing cataract surgery. Only those cases who had intraocular pressure <or= 21 mmHg over the preceding 6 months without any medical therapy following trabeculectomy were included in the study. All patients underwent phacoemulsification through a superior clear corneal, three-stepped, 1.5 mm long tunnelled incision and in-the-bag intraocular lens implantation. Surgical difficulties, complications, postoperative intraocular pressure and best-corrected visual acuity were studied and analysed over a follow up of 6 months.


RESULTS
Complications seen during the surgery were iris trauma in 11 eyes (18.33%), thermal corneal burn in four (6.6%), corneal oedema in seven (11.66%), vitreous loss in one (1.6%), breach in rhexis in two (3.3%), fibrinoid reaction in one (1.6%) and early increase in intraocular pressure in one (1.6%). Postoperatively, visual acuity improved in all cases. None of the patients had poor vision that could be attributed to the surgical procedures. Difference in intra-ocular pressure (preoperative 15.37 +/- 2.59 mmHg) at all occasions during follow up was found to be statistically insignificant (P > 0.05 using paired t-test). The central anterior chamber depth was statistically significant (P = 0.002) when preoperative (1.90 +/- 1.27 mm) was compared to postoperative at 6 months (2.11 +/- 1.27 mm).


CONCLUSIONS
Phacoemulsification in eyes with a functional filtering bleb for chronic angle closure glaucoma is challenging. However, with slight modifications in technique, it can be accomplished without compromising the functioning of the bleb.
Dr Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India. skhokhar38@hotmail.com
Sudarshan
S
Khokhar
Narottama
N
Sindhu
Mayank S
MS
Pangtey
D019923:Capsulorhexis; D002386:Cataract / Q000150:complications / Q000628:therapy; D002908:Chronic Disease; D005260:Female; D015812:Glaucoma, Angle-Closure / Q000150:complications / Q000601:surgery*; D006801:Humans; D007429:Intraocular Pressure; D007431:Intraoperative Complications; D019654:Lens Implantation, Intraocular; D008297:Male; D008875:Middle Aged; D018918:Phacoemulsification / Q000379:methods*; D011183:Postoperative Complications; D011446:Prospective Studies; D014130:Trabeculectomy; D014792:Visual Acuity