Abstract
Purpose :
Recent studies have shown that the average rate of zonulopathy in the general cataract population is 0.50%. It has also been shown that lens extraction may be an appropriate and cost-effective management of angle closure. Rates of zonulopathy in this specific population have not been extensively studied.
Methods :
This is a retrospective cohort study looking at 964 consecutive eyes with a diagnosis of PACS (254), PAC (355), and PACG (355) that underwent lens extraction by a single surgeon with a femtosecond laser procedure. The primary outcome measure was the rate of intra-operative zonulopathy. The presence of secondary pigment dispersion as well as the use of capsular hooks, CTRs, and anterior vitrectomy were also noted. Patients with a history of trauma, pseudo-exfoliation syndrome or other hereditary diseases were excluded. Chi-square tests were used to establish significance.
Results :
In the 964 eyes operated, zonulopathy was noted in the operative report in 32 (3.3%) eyes, 24 of which required CTR insertion (75% of zonulopathy cases). 1 case requiring capsular hooks, and 3 cases required anterior vitrectomy. The rates of zonulopathy in the individual groups were as follows: 7/254 PACS (2.8%), 16/355 PAC (4.8%), 11/355 PACG (3.1%), and 5/150 with secondary PDS (3.3%). There was no statistically significant difference between the 4 groups.
Conclusions :
The rate of zonulopathy in patients with PACS, PAC and PACG undergoing lens extraction was found to be significantly higher than reported in the general population. Secondary pigment dispersion is also associated with a higher rate of zonulopathy. Ophthalmologists should be aware of risks and be prepared to manage the zonulopathy intra-operatively.
This is a 2020 ARVO Annual Meeting abstract.