Outcomes of lensectomy with glued intraocular lens and factors associated with failure in eyes with spherophakia and glaucoma
Purpose: To evaluate the outcomes of lensectomy with a glued intraocular lens (IOL) in spherophakic eyes with secondary glaucoma and assess factors associated with failure. Methods: We prospectively evaluated outcomes of lensectomy with glued IOL in 19 eyes with spherophakia and secondary glaucoma...
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| Format: | Article |
| Language: | English |
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Wolters Kluwer Medknow Publications
2023-01-01
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| Series: | Indian Journal of Ophthalmology |
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| Online Access: | http://www.ijo.in/article.asp?issn=0301-4738;year=2023;volume=71;issue=6;spage=2487;epage=2492;aulast=Burugupally |
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| author | Keerthi Burugupally Sirisha Senthil Deepika C Parameshwarappa Hasnat Ali Divya Balakrishnan Chandrasekhar Garudadri |
| author_facet | Keerthi Burugupally Sirisha Senthil Deepika C Parameshwarappa Hasnat Ali Divya Balakrishnan Chandrasekhar Garudadri |
| author_sort | Keerthi Burugupally |
| collection | DOAJ |
| description | Purpose: To evaluate the outcomes of lensectomy with a glued intraocular lens (IOL) in spherophakic eyes with secondary glaucoma and assess factors associated with failure. Methods: We prospectively evaluated outcomes of lensectomy with glued IOL in 19 eyes with spherophakia and secondary glaucoma (intraocular pressure (IOP) ≥22 mm Hg and/or glaucomatous optic disc damage) between 2016 and 2018. The vision, refractive error, IOP, antiglaucoma medications (AGMs), optic disc changes, need for glaucoma surgery, and complications were assessed. Success was defined as complete when IOP was ≥5 and ≤21 mmHg without AGMs; qualified success as similar IOP with up to 3 AGM; the need for >3AGM/additional surgery for IOP control was considered a failure. Results: Preoperatively, the median (interquartile range: IQR) age was 18 (13.5–30) years. IOP was 16 (14–22.5) mmHg on a median of 3 (2,3) AGMs. Median postoperative follow up was 27.7 months (11.9, 39.7). Postsurgery, most patients achieved emmetropia, with significantly decreased refractive error from a median spherical equivalent of −12.5D to + 0.5D, P < 0.0002. The complete success probability was 47% (95% confidence intervals (CIs): 29–76%) at 3 months and was 21% (8 − 50%) at 1 year and 3 years. The qualified success probability was 93% (82–100%) at 1 year, which reduced to 79% (60–100%) in 3 years. None of the eyes had any retinal complications. The higher number of preoperative AGM was found to be a significant risk factor (p < 0.02) for the failure of complete success. Conclusion: One-third of the eyes had IOP control without the need for AGM postlensectomy with glued IOL. Surgery resulted in significant improvement in visual acuity. The higher number of preoperative AGM was associated with poor glaucoma control after glued IOL surgery. |
| first_indexed | 2024-03-12T22:30:22Z |
| format | Article |
| id | doaj.art-340000c0414a40b29f4bda5772f53a03 |
| institution | Directory Open Access Journal |
| issn | 0301-4738 1998-3689 |
| language | English |
| last_indexed | 2024-03-12T22:30:22Z |
| publishDate | 2023-01-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Indian Journal of Ophthalmology |
| spelling | doaj.art-340000c0414a40b29f4bda5772f53a032023-07-21T15:15:02ZengWolters Kluwer Medknow PublicationsIndian Journal of Ophthalmology0301-47381998-36892023-01-017162487249210.4103/ijo.IJO_1866_22Outcomes of lensectomy with glued intraocular lens and factors associated with failure in eyes with spherophakia and glaucomaKeerthi BurugupallySirisha SenthilDeepika C ParameshwarappaHasnat AliDivya BalakrishnanChandrasekhar GarudadriPurpose: To evaluate the outcomes of lensectomy with a glued intraocular lens (IOL) in spherophakic eyes with secondary glaucoma and assess factors associated with failure. Methods: We prospectively evaluated outcomes of lensectomy with glued IOL in 19 eyes with spherophakia and secondary glaucoma (intraocular pressure (IOP) ≥22 mm Hg and/or glaucomatous optic disc damage) between 2016 and 2018. The vision, refractive error, IOP, antiglaucoma medications (AGMs), optic disc changes, need for glaucoma surgery, and complications were assessed. Success was defined as complete when IOP was ≥5 and ≤21 mmHg without AGMs; qualified success as similar IOP with up to 3 AGM; the need for >3AGM/additional surgery for IOP control was considered a failure. Results: Preoperatively, the median (interquartile range: IQR) age was 18 (13.5–30) years. IOP was 16 (14–22.5) mmHg on a median of 3 (2,3) AGMs. Median postoperative follow up was 27.7 months (11.9, 39.7). Postsurgery, most patients achieved emmetropia, with significantly decreased refractive error from a median spherical equivalent of −12.5D to + 0.5D, P < 0.0002. The complete success probability was 47% (95% confidence intervals (CIs): 29–76%) at 3 months and was 21% (8 − 50%) at 1 year and 3 years. The qualified success probability was 93% (82–100%) at 1 year, which reduced to 79% (60–100%) in 3 years. None of the eyes had any retinal complications. The higher number of preoperative AGM was found to be a significant risk factor (p < 0.02) for the failure of complete success. Conclusion: One-third of the eyes had IOP control without the need for AGM postlensectomy with glued IOL. Surgery resulted in significant improvement in visual acuity. The higher number of preoperative AGM was associated with poor glaucoma control after glued IOL surgery.http://www.ijo.in/article.asp?issn=0301-4738;year=2023;volume=71;issue=6;spage=2487;epage=2492;aulast=Burugupallyectopia lentisglaucomaglued iolspherophakiasubluxated lens |
| spellingShingle | Keerthi Burugupally Sirisha Senthil Deepika C Parameshwarappa Hasnat Ali Divya Balakrishnan Chandrasekhar Garudadri Outcomes of lensectomy with glued intraocular lens and factors associated with failure in eyes with spherophakia and glaucoma Indian Journal of Ophthalmology ectopia lentis glaucoma glued iol spherophakia subluxated lens |
| title | Outcomes of lensectomy with glued intraocular lens and factors associated with failure in eyes with spherophakia and glaucoma |
| title_full | Outcomes of lensectomy with glued intraocular lens and factors associated with failure in eyes with spherophakia and glaucoma |
| title_fullStr | Outcomes of lensectomy with glued intraocular lens and factors associated with failure in eyes with spherophakia and glaucoma |
| title_full_unstemmed | Outcomes of lensectomy with glued intraocular lens and factors associated with failure in eyes with spherophakia and glaucoma |
| title_short | Outcomes of lensectomy with glued intraocular lens and factors associated with failure in eyes with spherophakia and glaucoma |
| title_sort | outcomes of lensectomy with glued intraocular lens and factors associated with failure in eyes with spherophakia and glaucoma |
| topic | ectopia lentis glaucoma glued iol spherophakia subluxated lens |
| url | http://www.ijo.in/article.asp?issn=0301-4738;year=2023;volume=71;issue=6;spage=2487;epage=2492;aulast=Burugupally |
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