gms | German Medical Science

For intraocular pressure regulation the use of a surgical iridectomy or laser iridotomy is the treatment of first choice. It has been proved that phacoemulsification or clear lens extraction including posterior chamber lens implantation led to intraocular pressure decrease. Additionally the visual acuity can be increased and the refraction corrected. Aim of this study is the comparison of phacoemulsification in angle closure with the partner eyes with or without iridectomy or iridotomy, respectively.

12 angle closure eyes with elevated intraocular pressure have been compared with 12 eyes with narrow angle or iridecomy / iridotomy respectivlely without intraocular elevation. Investigated parameter of these groups have been the development of the intraocular pressure, the visual acuity, the refraction and the use of antiglaucomateous drugs.

The averaged intraocular pressure in angle closure eyes was 47.4 mmHg , in the partner eyes 21.3 mm Hg preoperatively. Follow up pressure was 18.3 mm Hg for the angle closure and 16,4 mm Hg partner eyes. Averaged corrected visual acuity of the angle closure eyes raised from 0.29 mm Hg to 0.38 and for the partner eyes fom 0.37 to 0.56. The number of used antiglaucomateous drugs decreased from 1.2 preoperatively to 0.2 and for the partner eyes from 0.2 to zero.

Primary cataract extraction including posterior chamber implantation in angle closure eyes led to intraocular pressure regulation to normal range, increase of visual acuity and a decrease of the number of antiglaucomateous medication. Angle closure eyes do not respond differently to eyes with narrow angle without pressure elevation during and after phacoemulsification. Any possible adverse reaction of the laser iridotomy eyes is avoidable. A long term pressure elevation as in primary closure eyes should not be confused with angle closure eyes and does not respond to phacoemulsifi-cation and posterior chamber lens implantation with pressure normalization.