Individualized treatment of traumatic lens subluxation with cataract in patients with secondary glaucoma

Abstract

Objective To discuss the effective treatment for the cases of traumatic lens subluxation with secondary glaucoma and cataract. Methods The records of 28 cases (28 eyes) of traumatic lens subluxation with secondary glaucoma and cataract were reviewed. Various surgical procedures were performed according to the scope of lens subluxation and the condition of anterior chamber angle. Lens phacoemulsification (phaco) combined anterior vitrectomy were done for 17 eyes; Combined trabeculectomy were performed for 5 eyes; Lens phacoemulsification combined anterior vitrectomy and glaucoma drainage valve implantation were performed in 3 eyes; Pars plana vitrectomy combined lensectomy were done in 3 eyes. The postoperative visual acuity and intraocular pressure were observed for 6 months. Results Postoperative visual acuity of all cases were improved, The best corrective visual acuity were 0.05-0.6 at six months postoperatively; 25 cases had intraocular pressure (IOP) controlled. IOP in 3 cases (1 case with glaucoma valve implantation, 2 cases with trabeculectomy) with one or two medication of anti-glaucoma could be controlled below 21 mmHg. IOP in all cases was 18.71±2.24 mmHg at 6 months postoperatively. The difference of IOP between pre-operation and post-operation was statistically significant (t=32.62, P <0.01) except 2 eyes with 2 haptics stitching had IOL slightly offset, 26 eyes had the center position of IOL. Conclusions Individualized treatment can effectively control the intraocular pressure and improve the visual function in patients with secondary glaucoma after traumatic lens subluxation according to the different situation. Key words: Lens subluxation; Secondary glaucoma; Individualized treatment