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Category: Volume 08 Issue 01 January 2020
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Title: Changes in various ocular parameters in primary angle closure patients with cataract following phacoemulsification

Authors: Dr S. Walia, Dr Awani Dubey, Dr Neetu Kori, Dr Manushree Gautam

 DOI: https://dx.doi.org/10.18535/jmscr/v8i1.71

Abstract

Purpose: To assess intraocular pressure changes after phacoemulsification and its correlation with various intra ocular parameters in angle closure patients

Materials and Methods: We studied correlation of various ocular parameters with angle closure and change in intraocular pressure following phacoemulsification in patients aged 55-95 years with IOP>22 mm Hg on 2 or more occasions with angle closure on gonioscopy and cataract

Results: There were 35 angle-closure patients with cataract. Mean age was 73.37±7.42 years out of which 37.15% were male and 62.85% were females, ,60% had myopia, we found a negative correlation with anterior chamber depth (r=-0.468). We also found a positive correlation with, central corneal thickness (r=0.259) and lens thickness (r=0.064) Pre operative mean IOP was 27.60±6.03 while post operatively at 1 week, 2 week, 4 week,6 weeks,3 months was 13.69±2.88,12.23±2.70,12.56±2.51,12.11±2.42 at and 12.40±2.74 respectively .Pre operative gonioscopy scoring was 2.63±1.416 while post operatively at 6 weeks and 3 months was 13.29±1.545 and 13.71±1.416 respectively. Only one patient required antiglaucoma medications post operatively.

Conclusion: Phacoemulsification cataract surgery leads to significant decrease in IOP and increase in ACD in cataract patients with angle closure with peripheral anterior synechiae <180 degrees. Thick crystalline lens leads to angle closure through reduction of ACD and narrowing of angle. Thus cataract surgery may be a safe alternative to glaucoma surgery in angle closure patients and could shift the surgeon’s approach in treatment of concurrent cataract and glaucoma.

Keywords: Cataract Surgery, Phacoemulsification, Intraocular Pressure, Angle Closure.

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Corresponding Author

Dr Awani Dubey

Resident Doctor, Department of Ophthalmology, Mahatma Gandhi Memorial Medical College, M.Y. Hospital Indore (M.P.) 452001