The Profile and Management of Glaucoma in Adult Aphakic Patients Following Complicated Cataract Surgery

Abstract

Objectives: To determine the profile and clinical course of glaucoma in adult aphakic patients following complicated cataract surgery. Materials and Methods: Retrospective chart review of 22 adult aphakic patients (29 eyes) with glaucoma. Results: Mean age was 57.69±14.18 years when aphakia occurred. Mean age at time of presentation to our glaucoma clinic was 62.57±12.47 years. Mean follow-up time was 42.83±57.04 months. Changes between the first and last follow-up visits were as follows: mean intraocular pressure decreased from 26.21±13.86 mmHg to 18.14±9.63 mmHg (p=0.003); mean number of glaucoma medications used increased from 1.41±1.27 to 2.07±1.04 (p=0.005); and mean vertical cup/disc ratio increased from 0.69±0.25 to 0.78±0.24 (p=0.024). Glaucoma was managed using medications in 26 eyes (89.7%), whereas 3 eyes underwent surgical treatment. However, surgery alone was not sufficient to control intraocular pressure and additional glaucoma medications were needed. Conclusion: Prevention of glaucomatous optic neuropathy in aphakic patients is challenging both medically and surgically. Although a significant decrease in intraocular pressure can be achieved with glaucoma medications, glaucomatous disc changes may progress.

Keywords

• Aphakia
• glaucoma
• secondary glaucoma
• complicated cataract surgery