The treatment for ciliary block glaucoma

Abstract

Objective To investigate the efficacy of medical and surgical treatment for ciliary block glaucoma. Methods Eight eyes of 7 patients of ciliary block glaucima in our hospital from January 2010 to September 2013 were enrolled in the retrospective study. The effects of medical and surgical treatment, preoperative and postoperative visual acuity(VA)、intraocular pressure(IOP) and depth of anterior chamber were evaluated and analyzed. Results Six eyes of 5 cases received surgical treatment. Among 5 cases, 3 eyes of 2 patients were treated by phacoemulsification combined with intraocular lens implantation、posterior continuous curvilinear capsulorhexis (PCCC) and anterior vitrectomy (AV). One pseudophakic eye underwent PCCC and AV. One eye received intracapsular cataract extraction(ICCE) and AV without implantation of instraocular lens . The capsular tension ring was used in one case which complicated with lens subluxation. There was no recurrence of ciliary block glaucoma in patients after surgical treatment. The IOP was controlled well.Two eyes of two patients were treated with comprehensive medication, which included local cycloplegic, carbonic anhydrase inhibitor and glucocorticoid eyedrops.Of these two cases, one eye was cured with medication lasted for half an year and followed up 3.5 years; the other recurred 9 times in one year which recurred every time when stopping medication for one week. Conclusion Local cycloplegic and glucocorticoid, as the main medication of comprehensive treatment, in treatment of early ciliary block glaucoma partially, but easy to recur. Compared with medication treatment, phacoemulsification combined with intraocular lens implantation, PCCC and AV for the treatment of ciliary block glaucoma is a safe and effective method. Early and timely treatment is beneficial to the preservation of visual function. Key words: Glaucoma, ciliary block; Treatment; Anterior vitrectomy; Phacoemulsification; Posterior capsulorhexis