Офтальмохирургия (Oct 2020)
Dynamics of intraocular pressure after cataract phacoemulsification in combination with primary angleclosure glaucoma
Abstract
Purpose. Analysis of intraocular pressure after cataract phacoemulsification with IOL implantation in patients with cataract in combination with primary angle-closure glaucoma.Material and methods. The dynamics of IOP after phacoemulsification with IOL implantation was studied in 46 patients (58 eyes) with cataract in combination with angle-closure glaucoma. The initial stage of glaucoma was diagnosed in 5.17%; developed-in 70.69%; distant-in 24.14%. Intraocular pressure was normal at 77.59%, moderately elevated at 12.07%, and high at 10.34% in the hypotensive mode. Follow-up period was from 1 month to 2.5 year s.Results. Depending on the postoperative ophthalmotonus, patients were divided into three groups: IOP is equal to the preoperative level, IOP is lower than the preoperative indicators, and IOP is higher than the initial one. The level of ophthalmotonus corresponded to the preoperative level in most eyes during the entire follow-up period, and by the age of 2.5, the number of these patients reached 71.43%. The number of patients with intraocular pressure is lower than preoperative values (3–9 mm Hg) was 62.74% in the first months, and by the end of the observation period it decreased to 19.04%. Intraocular pressure higher than preoperative pressure (2–4 mm Hg) was registered in 20 eyes (34.48%). In one case, the increase in IOP did not exceed the statistical norm and did not require correction, in 14 eyes IOP was compensated by additional medication, and in 5 eyes with far-advanced glaucoma, surgery was required.Conclusion. After phacoemulsification of cataracts in closed-angle glaucoma, it is not always possible to obtain a sufficient and persistent hypotensive effect, which probably indicates that the iridocorneal angle of retention intraocular fluid in the outflow pathways is attached to the blockade, which requires further study.
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