Combined 23-G Pars Plana Vitrectomy and Lensectomy in the Management of Glaucoma Associated with Nanophthalmos

Abstract

Purpose: To investigate the surgical results of 23-G pars plana vitrectomy (PPV) combined with lensectomy (PPL) in nanophthalmic patients with angle closure glaucoma. Methods: This prospective nonrandomized study included consecutive patients with nanophthalmic glaucoma recruited for 23-G PPV combined with PPL. Best-corrected visual acuity (BCVA), intraocular pressure (IOP), the number of antiglaucoma medications, and surgery-associated complications were recorded. Surgical success rates were evaluated at each follow-up. Prognostic factors for success were also assessed using logistic regression analysis. Results: This study enrolled 21 eyes of 21 patients. The mean follow-up was 18.6 ± 7.0 months. At the final follow-up visit, the mean IOP was significantly reduced (from 47.4 ± 5.7 to 18.6 ± 3.6 mm Hg). The mean number of antiglaucoma medications dropped from 5 to 0. BCVA improved in 3 (14.3%) eyes. The complete success rate (IOP >6 and <21 mm Hg without antiglaucoma medication) was 71.4, 66.7, and 71.4% at the 6-month, 12-month, and final follow-up visit, respectively. Conclusions: Nanophthalmic glaucoma can be effectively managed with the combined surgery of 23-G PPV and PPL. IOP control was achieved with elimination of pupillary block and deepening of the anterior chamber. This surgical procedure proved to be safe in eyes with a potential risk of vision-threatening complications.