EAGLE ON MY SHOULDER – HOW TO MANAGE ANGLE CLOSURE GLAUCOMA

The purpose of the study is to prospectively perform clear lens extraction and follow over 3 year patients with angle closure glaucoma (ACG)

Clinical setting

Material and method: 76 eyes of 38 patients with ACG in one or both eyes, were treated with pressure lowering medications and operated with modified phacoemulsification. Most of the patients 31 were female, with mean age of 53 ± 8 years. The hyperopic correction was mean of 6.7± 2.9 diopters. The IOL was calculated with Barret universal formula, and was mostly EDOF, excluding the very high dioptric powers, where monofocal lens was implanted. The primary outcome measures were intraocular pressure measured with CORVIS and best corrected visual acuity in 3 years.

Results: All surgeries were uneventfully performed. On the first postoperative day some patients had low visual acuity of less 0.1, because of corneal edema. In three years after surgery the appreciation of general health improved with 1.7 points, the quality of life improved with 3.1 points, the limitations due to vision decreased with 4.1 points. The rest three questions (with different scale) showed little worries about the future, better accomplishments and less dependence on the others.

Conclusions: The improvement of life quality, performance and self-confidence, might be a result of either the permanent pain relief and refractive correction, but most likely is a combination of both. Clear lens extraction should be recognized as a therapeutic procedure for hyperopic patients with signs and symptoms of acute angle closure glaucoma.