Phacoemulsification with double-in-bag intraocular lens implantation in nanophthalmic eyes with angle-closure glaucoma.

Abstract

To report the outcomes of phacoemulsification with piggyback intraocular lens (IOL) implantation, with double-in-bag IOLs in the management of angle-closure glaucoma (ACG) in nanophthalmic eyes. This is a retrospective case series on nanophthalmic eyes with variable presentations of ACG. Phacoemulsification with double-in-bag IOL implantation was done for the included eyes. Baseline and follow-up corrected distance visual acuity (CDVA), spherical equivalent (SE), intraocular pressure (IOP), and the number of glaucoma medications were evaluated. Surgical details were extracted, and complications were recorded. Six eyes of three patients were included. The mean axial length was 17.24 ± 1.02mm. The mean preoperative IOP was 20 ± 2.7mmHg with medical treatment. The mean preoperative CDVA (logMar) was 0.83 ± 0.37 with mean SE 12.7 ± 1.77 diopters. The mean postoperative IOP at 3-month and 1-year follow-ups was 14 ± 5.3mmHg and 15.5 ± 4.1mmHg, respectively. Postoperative CDVA was 0.78 ± 0.41, with mean SE -0.04 ± 2 diopters. No significant intraoperative or postoperative complications were reported. One eye developed posterior capsule opacification (PCO), and another eye developed visually insignificant inter-lenticular opacification (ILO). In the evaluated nanophthalmic eyes with ACG, lens extraction with double-in-bag IOL implantation showed promising results regarding the IOP control as well as the visual and refractive outcomes.