Contribution of Ultrabiomicroscopy in Phacomorphic Glaucoma: A Prospective Study of 25 Eyes

Abstract

Phacomorphic glaucoma is the term used for secondary angle-closure glaucoma due to lens intumescence, leading to pupillary block and closure of the irido corneal angle (ICA). This condition presents as an acute glaucoma crisis due to angle closure, which can lead to serious complications. The aim of our study is to determine the usefulness of ultra biomicroscopic ultrasound (UBM) in the evaluation of the iridocorneal angle before and after cataract surgery in phacomorphic glaucoma. The prospective analytical study included 25 eyes diagnosed with phacomorphic glaucoma. The intraocular pressure, the visual acuity, the UBM parameters including; the Anterior Chamber Depth (ACD), the Trabecular-Iris Angle (AIT), the Angel Opening Distance (AOD500), were assessed preoperatively and postoperatively. The mean age of our patients was 74.7 years, there was no significant gender preference. The mean intraocular pressure (IOP) under maximal treatment was reduced from 45.36 5.4 to 25.8 mmHg in our study. With IOP at 17+/-2.5 to 15+/-1.3 after surgery within 1-3 days. The gonioscopic results were in agreement with the UBM results, which provided more specific angle measurements; all angle parameters are improved after cataract surgery. All eyes had a mean angle of more than 20° in all four quadrants with a mean angle of (37.1+/-4.5), very similar to the angle status of the uninvolved eye. In conclusion, after an acute attack of angle closure of phacomorphic origin, all parameters of the ICA measured by UBM increased significantly as well as normalization of IOP after cataract surgery