Evaluation of biometric parameters in phacomorphic glaucoma and mature cataracts

Abstract

Purpose: The aims of this study were to compare the biometric parameters and axial lengths of eyes with phacomorphic glaucoma and mature cataract and to identify differences that might predispose to development of phacomorphic glaucoma. Methods: Three hundred forty-two patients were enrolled in this retrospective study. The eyes were divided into four groups—Group (G)1: phacomorphic glaucoma ( n = 29), G2: mature cataract ( n = 313), G3: contralateral phacomorphic glaucoma ( n = 29), and G4: contralateral mature cataract ( n = 313). Central corneal thickness and anterior chamber depth were assessed by optical low-coherence reflectometry (Lenstar LS 900®; Haag-Streit AG, Switzerland), while axial length was determined by A-scan ultrasound biometry. Results: The mean central corneal thickness of G1 was significantly higher than in other groups ( p < 0.001) and the mean anterior chamber depth of G1 was the lowest among the groups ( p < 0.001). Also, G2 had lower mean anterior chamber depth than G4 ( p < 0.001) and G3 had lower mean anterior chamber depth than G4 ( p = 0.007). Anterior chamber depth less than 3.27 mm had the higher odds ratio for distinguishing G3 versus G4 (odds ratio = 10.79, p < 0.001). Furthermore, patients aged ⩾68.9 years had the higher odds ratio for distinguishing G1 versus G2 (odds ratio = 2.82, p = 0.019). There was no significant difference in the presence of pseudoexfoliation material between G1 and G2 ( p = 0.057). There were no significant differences in axial length values among the four groups ( p = 0.097). Conclusion: Advanced age and shallow anterior chamber depth were found to be risk factors for developing phacomorphic glaucoma, but the presence of pseudoexfoliation material was not found to play a role as a risk factor in phacomorphic glaucoma development.

Outcomes and favourable prognostic factors in patients of phacomorphic and phacolytic glaucoma managed by manual small-incision cataract surgery: A retrospective study

“…While a phacomorphic glaucoma is essentially a pupillary-block-mediated secondary angle closure, a phacolytic glaucoma is a trabecular form of secondary open-angle glaucoma. [ 24 25 ] Relief of the pupillary block should therefore cause a lowering of IOP in a phacomorphic glaucoma unless there has been prolonged irido-trabecular contact leading to the formation of extensive synaechial angle closure. [ 1 ] In contrast, the IOP in phacolytic glaucoma is likely to be high even after cataract extraction until the trabecular function is restored and the violent inflammatory reaction subsides.…”

Accuracy of different lens power calculation formulas in patients with phacomorphic glaucoma

“…[ 2 ] Emergent preoperative IOL power calculation is almost always challenging due to inadequate view to perform optical biometry, elevated IOP and consequent corneal edema and anteriorly displaced hypermature lens shallowing the anterior chamber and altering its anatomic relationships. [ 1 2 3 ] In the present study we compare various IOL power formulas to investigate the accuracy of IOL power calculation and to predict the refractive outcomes in eyes with PG.…”

“…It is mostly associated with aging and inadequate access to medical and surgical care services and delay in cataract extraction especially in developing countries with 3.91% prevalence. [ 1 2 ]…”

“…These predisposing factors change the configuration of the anterior chamber to be at risk of PG, however the anteriorly-displaced swollen cataract is the main pathology and deep anterior chambers may also be affected. [ 1 4 ] After cataract extraction as a definitive treatment, deepening of the anterior chamber is occurred and consequent postoperative declining IOP leads to a decrease in axial length. [ 4 5 6 7 8 9 10 ] Moreover, corneal edema and mature intumescent cataract in PG prohibit the use of optical biometry in IOL power calculation.…”

Glaukoma Fakomorfik: Sebuah Tinjauan Pustaka

“…Sebagian besar pasien dengan glaukoma fakomrofik berusia antara 50 hingga 60 tahun.6 Beberapa studi menunjukkan bahwa proses penuaan dapat mengakibatkan panjang aksial yang berkurang, yang juga ditemukan pada penelitian yang dilakukan oleh Keles dan Elgin, meskipun tidak signifikan.10 Keles dan Elgin juga menemukan bahwa usia tua berhubungan dengan berkurangnya kedalaman bilik mata depan, serupa dengan temuan dari Fernandez-Vigo dkk yang menyatakan bahwa kedalaman bilik mata depan dipengaruhi oleh usia, jenis kelamin, spherical error, dan diameter kornea. 10,11 Hipermetropia juga merupakan salah satu faktor risiko terjadinya glaukoma fakomorfik, karena kondisi ini diasosiasikan dengan bilik mata ISSN 2301-5977, e-ISSN 2527-7154 jku.unram.ac.id depan yang pendek.5 Lee dkk menemukan rerata panjang aksial pasien glaukoma fakomorfik dalam penelitiannya adalah 22,3 ± 0,6 mm yang mendukung pendapat ini.12 Penelitian yang dilakukan oleh Lee dkk menunjukkan bahwa mata dengan glaukoma fakomorfik memiliki panjang aksial yang lebih pendek dibandingkan mata pada usia dan jenis kelamin yang sama. Panjang aksial ≤ 23,2 mm memiliki risiko untuk mengalami glaukoma fakomorfik 4,3 kali lebih besar dibandingkan mata dengan panjang aksial diatas 23,7 mm.…”