A prospective study of 413 cases of lens-induced glaucoma in Nepal

<b>Purpose:</b> To determine the frequency and types of lens-induced glaucoma (LIG), reasons for late presentation and outcome of current management. <b>Methods:</b> Prospective case series of 413 patients/eyes with LIG over a 12-month period in 1998; 311 of these patients un...

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Bibliographic Details
Main Authors: Pradhan Damodar, Hennig Albrecht, Kumar Jitendra, Foster Allen
Format: Article
Language:English
Published: Wolters Kluwer Medknow Publications 2001-01-01
Series:Indian Journal of Ophthalmology
Subjects:
Online Access:http://www.ijo.in/article.asp?issn=0301-4738;year=2001;volume=49;issue=2;spage=103;epage=107;aulast=Pradhan
Description
Summary:<b>Purpose:</b> To determine the frequency and types of lens-induced glaucoma (LIG), reasons for late presentation and outcome of current management. <b>Methods:</b> Prospective case series of 413 patients/eyes with LIG over a 12-month period in 1998; 311 of these patients underwent cataract surgery. Visual acuity and intraocular pressure (IOP) were pre-and postoperatively assessed. <b>Results:</b> Four hundred and thirteen (1.5&#x0025;) of 27,073 senile cataracts seen in the outpatient department of Sagarmatha Choudhary Eye Hospital, Lahan, Nepal presented with LIG. There were 298 (72&#x0025;) phacomorphic cases and 115 (28&#x0025;) phacolytic glaucoma. Pain for more than 10 days was reported by 293 (71&#x0025;) patients. The majority, 258 (62.4&#x0025;), travelled a distance of more than 100 kms to the hospital. The major reasons for late presentation were "no escort" in 143 (34.6&#x0025;) and "lack of money" in 128 (31.0&#x0025;) cases. At presentation the IOP was more than 30 mm Hg in 327 (79&#x0025;) eyes. Following cataract surgery, 251 (80.7&#x0025;) had 21 mm Hg or less at discharge. The visual acuity was hand-movement or less before surgery in all eyes; at discharge 120 of 311 operated eyes (38.6&#x0025;) achieved 6/60 or better, 97 (31.2&#x0025;) less than 6/60, and 94 (30.2&#x0025;) less than 3/60. The main causes for poor outcome in 94 cases were optic atrophy in 32 (34&#x0025;) eyes, uveitis in 25 (26.6&#x0025;)eyes and corneal oedema in 24 (25.5&#x0025;) eyes. <b>Conclusion:</b> The results highlight the importance of early diagnosis and treatment of visually disabling cataract. There is a need to educate both the patient and the cataract surgeon of the dangers of lens-induced glaucoma and of the poor outcome if treatment is delayed.
ISSN:0301-4738