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ISSN 1561-3070 (Electronic)

2016, Number 3

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Rev Cub Oftal 2016; 29 (3)

Results of three surgical alternatives for the crystalline lens extraction in the acute primary angle-closure

Fernández AL, Padilla GCM, Cárdenas CD, Fumero GFY, Piloto DI, Ortuño ÁDM

Language: Spanish
References: 34
Page: 420-431
PDF size: 154.65 Kb.


ABSTRACT

Objective: to evaluate the effectiveness of the crystalline lens extraction in the treatment of the acute primary angle-closure.
Methods: prospective, longitudinal and descriptive study of a case series of 27 eyes from the same number of patients suffering acute primary angle-closure, distributed according to three alternatives: phacoemulsification (n=7, phaco), sclerocorneal tunnel (n=12, tunnel) and postrabeculectomy tunnel (n=8, post-TBT tunnel). The variables intraocular pressure and number of hypotensive eyedrops used in the preoperative and postoperative period were analyzed a week, a month, three months, six months, one year and two years after the surgery as well as sphere, cylinder and best corrected visual acuity in the preoperative phase and two years after surgery.
Results: postoperative intraocular pressure was steady in the course of time in the three groups (12-14 mmHg). Two years later, there had been a significant reduction of average intraocular pressure in the tunnel group (3.83 ± 5.27 mmHg; p= 0.032), of the number of hypotensive eyedrops used in the phaco group (1.29 to 0.14; p= 0.038) and the tunnel group (1.33 to 0.25; p= 0.006). Myopia in the post-TBT tunnel group (-1.16 ± 1.12 D; p= 0,028) and astigmatism in the tunnel group (1.00 ± 1.05 D; p= 0.016) were both induced. The best average corrected visual acuity increased in the three groups, being significant in the tunnel and the post-TBT tunnel groups (p= 0.003 and p= 0.012, respectively.
Conclusions: in those patients with acute primary angle-closure, phacoemultification and sclerocorneal tunnel reduce the intraocular pressure and the number of hypotensive eyedrops to be used in 2 years-term and the hypotensive power of a previous filtering bleb. The three variants can effectively recover the visual acuity whereas the myopic error of one diopter is induced in patients with previous trabeculectomy and one diopter astigmatism through the sclerocorneal tunnel.


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