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Natalie Juarez Reyna, Alejandra Hernandez-Oteyza, Magdalena García-Huerta, Jesus Jimenez-Roman, Armando Castillejos-Chévez, glaucoma associated with lens; Retrospective analysis of glaucoma associated with lens in Asociación para Evitar la Ceguera en México. Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):2688.
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To study cases of glaucoma associated with lens that have been treated in the Asociación para Evitar la Ceguera en México (APEC) over the past 20 years. To determine how many cases of phacomorfic, phacolytic and phacoanaphylactic glaucoma were treated and determine the clinical presentation, medical and surgical managments, visual prognosis and if there is any relationship between the duration of the acute attack and a poor prognosis
We carried out a retrospective, cross-sectional, observational and descriptive study. All records of patients with glaucoma associated with lens were studied over a period of 20 years (1994-2013) in APEC.
We found 59 patients: 42 eyes with phacomorphic glaucoma (71.1%), 13 with phacolytic glaucoma (22%) and 4 with phacoanaphylactic glaucoma (6.7%). Of The patients with phacomorphic 83% were female. With an average age of 70.47 ± 11.3 years, a visual capacity (VC) on admission of logMAR 2.38 ± 0.48 and final VC of 1.23 ± 0.79. Average of intraocular pressure (IOP) on admition was 43.75 ± 13.55 mmHg on 2.91 ± 0.9 glaucoma drugs and final IOP was 11.36 ±3.19 on 0.81 ± 1.47 drugs. The average time between the acute attack and surgery was 7.7 ± 10.5 days. Surgical treatment consisted on combined glaucoma and cataract surgery in 50% of the cases and cataract alone on the other 50%; decided by the surgeon. Of patients with phacolytic 54% were female, mean age of 69.61 ± 12.89 years , VC on admission was 2.52 ±0.19 and 1.0 ±1.41 at final visit. With an average presurgical IOP of 44.08±10.62 mmHg on 2.5 ± 0.90 drugs and a final IOP of 11.74 ±1.29 on 1.25±1.5 drugs. The average time between the acute attack and surgery was 15.6 ± 24 days. Treatment consisted on cataract extraction on 100%. We found 4 patients with phacoanaphylactic glaucoma of whom 3 had a history of trauma and one had a history oftrauma and surgery. They had a mean age of 40.5 ±13 years and an initial mean IOP of 42.67 ± 5.24 mmHg.
The patients with glaucoma associated with lens treated in our hospital were more frequently females; this is propably due to a smaller eye size, and are more frequent in the sixth decade of life. The greatest incidence corresponds to phacomorphic glaucoma. We note that there are two factors of poor prognosis, one is the time between acute attack and surgical treatment and second is a visual acuity at first visit worse than light perception.
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