Phacoemulsification in prevention of acute angle-closure glaucoma attack

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PURPOSE

To study the changes in morphometric parameters of the anterior segment of anatomically short eyes with an increased risk of acute glaucoma attack before and after preventative PE.

MATERIAL AND METHODS

The study included 70 patients (70 eyes) with a high risk of acute glaucoma attack in short anatomical axial length and thickened lens, with posterior and middle positions of the ciliary body. They were divided into 2 groups: the main group consisted of 45 patients who agreed to undergo PE; the comparison group consisted of 25 patients who refused to undergo PE due to good visual functions and no complaints about vision. B-mode ultrasound examination of the anterior segment of the eye was used to evaluate the cross-sectional surface area of the lens (CSAL) and the cross-sectional surface area of the anterior chamber (CSAAC).

RESULTS

In the main group, on day 2—3 after PE the anterior chamber depth increased in all eyes, the CSAAC index increased, the anterior chamber angle (ACA) widened to Schaffer grade to II—III. After 1—3 years and 4—5 years, the anterior chamber depth, the CSAAC index and the width of the ACA remained stable. In the comparison group, after 1—3 years the anterior chamber depth and the CSAAC index significantly decreased, the ACA narrowed, and the intraocular pressure increased; after 4—5 years, there was a progressive increase in the CSAL index, the ACA was completely closed (0°).

CONCLUSION

In all cases of timely performed preventative PE, already on days 2—3 after surgery there was a statistically significant improvement in the main morphometric parameters of the eye, which remained stable for 4—5 years.

Keywords:

hyperopia

angle-closure glaucoma

risk calculation formula

phacoemulsification

axial eye length

Authors:

Sorokin E.L.

Khabarovsk branch of S.N. Fedorov National Medical Research Center “MNTK “Eye Microsurgery”;
Far-Eastern State Medical University

ORCID: 0000-0002-2028-1140

Marchenko A.N.

Khabarovsk branch of S.N. Fedorov National Medical Research Center «MNTK «Eye Microsurgery»»

Pashentsev Y.E.

Khabarovsk branch of S.N. Fyodorov National Medical Research Center «MNTK «Eye Microsurgery»

Received:

30.12.2020

Accepted:

11.03.2021

List of references:

Hadiri K. Assessment of prognostic coefficients as predictors of primary angle-closure glaucoma development. National Journal glaucoma = Natsional’nyy zhurnal glaukoma. 2020;19(1):35-38. (In Russ.). https://doi.org/10.25700/NJG.2020.01.05
Kochergin SA, Beisekeeva JS, Samoylenko AI, Alekseev IB. Long period follow-up results after phacoemulsification in eyes with primary chronic angle-closure glaucoma. Kataraktal’naya i refraktsionnaya khirurgiya. 2011; 11(3):16-18. (In Russ.).
Egorova EV, Fayzieva US. Phacoemulsification is an operation of choice in primary angle closure glaucoma with block induced by the lens Glaukoma. Zhurnal NII GB RAMN. 2012;(3):36-41. (In Russ.).
Thomas R, Arun T, Muliyil J, George R. Outcome of laser peripheral iridotomy in chronic primary angle-closure glaucoma. Ophthalm Surg Lasers. 1999;30(7):547-553.
Marchenko AN, Sorokin EL, Pashentcev YaE. Effectiveness of the system for predicting the risk of developing an acute angle closure glaucoma attack. Vestnik oftal’mologii. 2019;135(1):47-52. (In Russ.). https://doi.org/10.17116/oftalma201913501147
Selvan H, Angmo D, Tomar AS, Yadav S, Sharma A, Dada T. Changes in intraocular pressure and angle status after phacoemulsification in primary angle closure hypertension. J Glaucoma. 2019;28(2):105-110. https://doi.org/10.1097/ijg.0000000000001137
Costa VP, Leung CKS, Kook MS, Lin SC; Global Glaucoma Academy. Clear lens extraction in eyes with primary angle closure and primary angle-closure glaucoma. Surv Ophthalmol. 2020;65(6):662-674. https://doi.org/10.1016/j.survophthal.2020.04.003
Sorokin EL, Marchenko AN, Danilov OV. Role and clinical value of phacomorphic component in formation of primary closed-angle glaucoma in case of a thickened lens form (towards a problem of genesis of closed-angle glaucoma). Report 1. Fyodorov Journal of Ophthalmic Surgery = Oftal’mokhirurgiya. 2014; (1):53-59. (In Russ.).
Sorokin EL, Posvalyuk VD, Marchenko AN, Danilov OV. Criteria of choice for an optimal method of hyperopic refractive surgery in eyes with risk of phacomorph glaucoma. Fyodorov Journal of Ophthalmic Surgery = Oftal’mokhirurgiya. 2011;(4):23-27. (In Russ.).
Pravosudova MM, Balashevich LI, Somov EE Phacoemulsification with IOL implantation in patients with angle-closure glaucoma. Fyodorov Journal of Ophthalmic Surgery = Oftal’mokhirurgiya. 2005;(2):18-20. (In Russ.).
Moshetova LK, Cochergin SA, Alekseev IB, Samoylenko AI, Beisekeeva JS. Anatomic-functional changes in anterior chamber after phacoemulsification in eyes with primary angle-closure glaucoma. Glaukoma. Zhurnal NII GB RAMN. 2011;(2):44-51. (In Russ.).
Holevinskaya OV. Phacoemulsification of cataract in patient with closed-angle glaucoma. Ophthalmology. Eastern Europe = Oftal’mologiya. Vostochnaya Yevropa. 2020;10(2):248-259. (In Russ.).
Bakunina NA, Kolesnikova LN. Changes of optical coherent tomography parameters after phacoemulsification in acute angle-closure glaucoma. Russian Ophthalmological Journal = Rossiyskiy oftal’mologicheskiy zhurnal. 2017; 10(2):10-16. (In Russ.). https://doi.org/10.21516/2072-0076-2017-10-2-10-16
Pravosudova MM, Balashevich LI, Efimov OA. Anterior eye chamber changes of patients with primary angle-closure glaucoma after lensectomy. Vestnik Sankt-Peterburgskogo universiteta. Meditsina. 2012;(2):132-139. (In Russ.).
Kalizhnikova EA. Impact of cataract phacoemulsification with intraocular lens implantation in the uveoscleral outflow rates in patients without glaucoma. the first results. Vestnik Tambovskogo universiteta. Seriya: Estestvennye i tekhnicheskiye nauki. 2015;20(3):591-595. (In Russ.).
Chubar VS. Vozmozhnosti fakoemul’sifikatsii katarakty v normalizatsii vnutriglaznogo davleniya pri nachal’noy stadii otkrytougol’noy glaukomy na fone psevdoeksfoliativnogo sindroma: Dis. ... kand. med. nauk [Possibilities of phacoemulsification of cataract in the normalization of intraocular pressure at the initial stage of open-angle glaucoma against the background of pseudoexfoliation syndrome: Dis. ... kand. med. nauk. M. 2016. (In Russ.). https://eyepress.ru/avtoreferat.aspx?287
Yugay MP, Ryabtseva AA, Shirinova UA. Anatomo-topographic and hydrodynamic parameters of the eye after cataract phacoemulsification. Almanac of Clinical Medicine = Al’manakh klinicheskoy meditsiny. 2015;(36):9-12. (In Russ.). https://doi.org/10.18786/2072-0505-2015-36-9-12
Lin MM, Rageh A, Turalba AV, Lee H, Falkenstein IA, Hoguet AS, Ojha P, Rao VS, Ratanawongphaibul K, Rhee DJ, Shen LQ, Song BJ, Chen TC. Differential efficacy of combined phacoemulsification and endocyclophotocoagulation in open-angle glaucoma versus angle-closure glaucoma. J Glaucoma. 2019;28(5):473-480. https://doi.org/10.1097/IJG.0000000000001225
Kim WJ, Kim JM, Kim KN, Kim CS. Effect of preoperative factor on intraocular pressure after phacoemulsification in primary open-angle glaucoma and primary angle-closure glaucoma. Korean J Ophthalmol. 2019;33(4): 303-314. https://doi.org/10.3341/kjo.2018.0135
Wang N, Jia SB. Phacoemulsification with or without goniosynechialysis for angle-closure glaucoma: a global Meta-analysis based on randomized controlled trials. Int J Ophthalmol. 2019;12(5):826-833. https://doi.org/10.18240/ijo.2019.05.20
Zhang H, Tang G, Liu J. Effects of phacoemulsification combined With goniosynechialysis on primary angle-closure glaucoma. J Glaucoma. 2016;25(5): 499-503. https://doi.org/10.1097/IJG.0000000000000297
Yan C, Han Y, Yu Y, Wang W, Lyu D, Tang Y, Yao K. Effects of lens extraction versus laser peripheral iridotomy on anterior segment morphology in primary angle closure suspect. Graefes Arch Clin Exp Ophthalmol. 2019;257(7): 1473-1480. https://doi.org/10.1007/s00417-019-04353-8
Shokoohi-Rad S, Karimi F, Zarei-Ghanavati S, Tireh H. Phacoemulsification, visco-goniosynechialysis, and goniotomy in patients with primary angle-closure glaucoma: A comparative study. Eur J Ophthalmol. 2019; 1120672119879331. https://doi.org/10.1177/1120672119879331
Tian T, Li M, Pan Y, Cai Y, Fang Y. The effect of phacoemulsification plus goniosynechialysis in acute and chronic angle closure patients with extensive goniosynechiae. BMC Ophthalmol. 2019;19(1):65. https://doi.org/10.1186/s12886-019-1070-9
Moghimi S, Latifi G, ZandVakil N, Mohammadi M, Khatibi N, Soltani-Moghadam R, Lin S. Phacoemulsification versus combined phacoemulsification and viscogonioplasty in primary angle-closure glaucoma: a randomized clinical trial. J Glaucoma. 2015;24(8):575-582. https://doi.org/10.1097/IJG.0000000000000196
Sorokin EL, Marchenko AN, Danilov OV. Dynamics of morphometric indices of hypermetropic eyes in different age periods of life and their significance for the formation of phacomorphic glaucoma. Glaukoma = Glaukoma. 2009;(4):9-13. (In Russ.).
Danilov OV, Sorokin EL, Savchenko NV, Marchenko AN. Diagnostic possibilities of a 20 MHz ultrasonic gauge application in ophthalmologic researches. Fyodorov Journal of Ophthalmic Surgery = Oftal’mokhirurgiya. 2012; (3):69-71. (In Russ.). https://eyepress.ru/article.aspx?11192

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