Surgery for cataract with extremely shallow anterior chamber after trabeculectomy

Abstract

Objective To investigate the efficacy of surgery for cataract with extremely shallow anterior chamber after trabeculectomy. Methods The data of 5 eyes of 5 cases of cataract with extremely shallow anterior chamber after trabeculectomy from Jan. 2017 to Mar. 2018 were analyzed retrospectively. Preoperative manifestation of all cases were cystoid or flat filtering blebs, anterior and posterior synechia, disappeared anterior chamber, mature white lens and high intraocular pressure (IOP). All patients underwent vitreous puncture and fluid releasing via the pars plana combined with goniosynechialysis, phacoemulsification and intraocular lens implantation. The patients were followed up for 6-12 months. Results The anterior chamber was formed in all 5 cases during operation. Preoperative best corrected visual acuity were light perception or hand motion, and the postoperative visual acuity was 0.2-0.4. The mean preoperative IOP was (38.80±11.44) mmHg (1 mmHg=0.133 kPa), and the mean postoperative IOP at the final visit was (15.80±2.02) mmHg (P<0.01). The difference of IOP was statistically significant between before and after operation. Anterior chamber disappeared before operation, and the mean postoperative central anterior chamber depth at the final visit was significantly increased to (2.81±0.21) mm (P<0.001). At 6 months after operation, the loss rate of corneal endothelial cells was 18.4%. No severe complication occurred during and after operation. Conclusion The combined surgery for the treatment of cataract with extremely shallow anterior chamber after trabeculectomy can resolve pupillary block, deepen the anterior chamber and reduce IOP. Key words: Cataract; Anterior chamber, shallow, extremely; Glaucoma; Puncture, vitreous