A Review of 100 Cases of Ectopia Lentis with Glaucoma: Its Types, Presentation, Management and Visual Prognosis

Abstract

Purpose: To examine the clinical profile of glaucoma associated or caused by ectopia lentis, its types and management and visual prognosis.

Material and Methods: The medical record of 100 consecutive patients suffering from Ectopia lentis and glaucoma admitted in Eye Unit of Khyber Teaching Hospital, Peshawar from June 2002 to December 2007 were reviewed retrospectively. The clinical records were analyzed. The main parameters were type of glaucoma, its management, visual prognosis and IOP control.

Results: No age and sex was exempted. Main types of glaucoma were pupillary block 26.92% (35 eyes), angle anomaly 18.46% (24 eyes), glaucoma due to lens in the anterior chamber 16.92% (22 eyes), traumatic glaucoma 14.61% (19eyes), phacolytic glaucoma in 10% (13 eyes) followed by mixed type of glaucoma 16.16% (18 eyes). In 87.69% (114 eyes) surgical intervention done as peripheral iredectomy in 33.08% (43 eyes), trabeculectomy 13.85% (18 eyes), phacotrabeculectomy in 9.23% (12eyes), lensectomy in 23.08% (30 eyes) and lensectomy with vitrectomy in 8.46% (11 eyes). Glaucoma was completely relieved in 74.62% cases while 25.48% (43 eyes) needed antiglaucoma medication. Visual acuity was improved in 70.77% (92 eyes). Amblyopia, optic disc cupping and optic atrophy were the main causes of visual failure.

Conclusion: Glaucoma in ectopia lentis patients is very common. In more than 80 % cases need surgical intervention like crystalline lens removal plus glaucoma surgery. Even after surgery chances of refractory glaucoma is there.