Visual Outcome in Lens Induced Glaucoma

Author(s): Geetha Arcot1 , Bommana Ugandhar Reddy2

BACKGROUND Lens Induced Glaucoma (LIG) is a type of secondary glaucoma and is an ocular emergency. It has varied visual outcomes depending on the type and time of presentation after the onset of attack. Thus, the analysis of the magnitude of LIG and assessment of visual outcome after cataract surgery in patients attending tertiary care centers like Regional Eye Hospital, Kurnool, would provide valuable information regarding its morbidity and incidence of blindness. METHODS This is a prospective study done in Regional Eye Hospital, Kurnool, conducted from November 2017 to May 2018. RESULTS In this study, we observed that about 50% of cases were above 60 yrs. of age. The incidence of LIG was more common in females than males in a ratio (F:M-3:2). Phacomorphic glaucoma (67%) was more common than other types. Most patients presented within 3 days of onset. 90% of cases had IOP > 30 mmHg at the time of presentation. SICS/ECCE with PCIOL with peripheral iridectomy was done in 60% of cases. We observed that postop IOP was under control in patients who underwent simple lens extraction with peripheral iridectomy. With early intervention and surgery, post-op complications like exudative membrane, iritis, & glaucomatous optic atrophy was found to be less. In this study, visual acuity after post-op was good in patients (48%) who underwent early treatment and surgery along with peripheral iridectomy after onset of attack. CONCLUSIONS Incidence of LIG is increasing in our society due to the negligence of older people in India due to the lack of attention given to them, especially older women. At the end of 6 weeks, we observed good visual outcome in patients who presented early and treated early after the onset of the attack. In the case of late presentation, lens extraction with PCIOL with peripheral iridectomy showed good visual outcomes.