Phacoemulsification for treatment of a shallow anterior chamber caused by lens subluxation after trabeculectomy

Abstract

Objective To assess phacoemulsification for treatment of a shallow anterior chamber or chronic elevated intraocular pressure caused by lens subluxation after trabeculectomy.Methods A retrospective analysis was conducted on 7 patients (8 eyes) who underwent phacoemulsification with a capsular tension ring (CTR) and intraocular lens (IOL) implants after trabeculectomy.Lens subluxation was diagnosed by ultrasound biomicroscopy (UBM).Changes in visual acuity,intraocular pressure (IOP) and anterior chamber depth before and after the operation were compared using a paired samples t test.Results Phacoemulsification was performed 67.4±34.9 days (30-125 days)after trabeculectomy.Preoperative uncorrected visual acuity (UCVA) (LogMAR) was 0.61±0.36.Postoperative UCVA was 0.16±0.09 at 1 month,which was much better than preoperative UCVA (t=3.629,P＜0.01).Preoperative best corrected visual acuity (BCVA) was 0.38±0.32 (logMAR).Postoperative BCVA was-0.01±0.10 at 1 month,which was also much better than preoperative BCVA (t=3.898,P＜0.01).Preoperative IOP was 25.45±6.92 mmHg.Postoperative IOP was 15.28±0.76 mmHg at 1 month (t=4.234,P＜0.01).The IOP of all subjects was well controlled without medication.Preoperative central anterior chamber depth was 1.20±0.36 mm.Postoperative central anterior chamber depth was 2.57±0.38 mm at 1 month (t=-11.075,P＜0.01).The extent of lens subluxation was 99.38°±46.02° (90°-180°) found during the operation.Conclusion A shallow anterior chamber or chronic elevated intraocular pressure caused by lens subluxation can be alleviated by phacoemusification with a CTR and IOL implantation. Key words: Phacoemulsification; Lens subluxation; Trabeculectomy; Shallow anterior chamber