Skip to main content
Log in

Uncontrolled primary angle closure glaucoma: results of early intercapsular cataract extraction and posterior chamber lens implantation

  • Published:
International Ophthalmology Aims and scope Submit manuscript

Abstract

In this study we retrospectively evaluated the effect of intercapsular or extracapsular cataract extraction and posterior chamber lens implantation in 67 eyes of 57 patients with different types of primary angle closure glaucoma (PACG) in combination with cataract. We subdivided this patient population into three groups, based on the preoperative methods of intraocular pressure (IOP) control. The best results were obtained in patients with acute PACG (55% IOP reduction) and in patients with uncontrolled PACG (44% IOP reduction). In the other PACG groups an IOP reduction of between 20 and 33% was achieved. A long-term postoperative IOP of less than 21 mmHg was established in 63 eyes or 94%.

In 91% the glaucoma medication was reduced, 65% of all eyes needed no glaucoma medication post-operatively.

We conclude that an intercapsular cataract extraction with PC-IOL implantation should be considered in both controlled and uncontrolled PACG in patients with cataract, instead of filtering surgery or combined procedures.

Even in eyes with relatively good visual acuity, cataract extraction might be considered as a means of achieving glaucoma control.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Apple DJ, Reidy JJ, Googe JM et al. A comparison of ciliary sulcus and capsular bag fixation of posterior chamber intraocular lenses. Am Intraocular Implant Society J 1985; 11(1): 44–68.

    Google Scholar 

  2. Apple DJ, Mandis N, Loftfield K et al. Complications of intraocular lenses. A historical and histopathological review. Survey of Ophthalmology 1984; 29(1): 1–54.

    Google Scholar 

  3. Arnott EJ. Insertion of posterior chamber implants and glaucoma. Glaucoma 1985; 7: 188–9.

    Google Scholar 

  4. Binkhorst CD. Preexisting primary glaucoma and intraocular lenses. Trans Ophthalmol Soc UK 1985; 104: 567–9.

    Google Scholar 

  5. Binkhorst CD. Safe all-in-the-bag pseudophakia with a new lens design (The Moustache lens). Document Ophthalmologica 1985; 59: 57–69.

    Google Scholar 

  6. Brems RN, Apple DJ, Pfeffer BR et al. Posterior chamber intraocular lenses in a series of 75 autotopsy eyes. J Cataract Refract Surgery 1986; 12(4): 358–71.

    Google Scholar 

  7. Civerchia LL, Balent A. Intraocular lens implantation in acute angle closure glaucoma associated with cataract. Am Intraocular Implant Soc J 1985; 11: 171–73.

    Google Scholar 

  8. Epstein EL. Angle Closure Glaucoma. In: Chandler and Grant's Glaucoma, Philadelphia Lea and Febiger publishers. 3, Ch 10, 1986; p 258.

  9. Gieser DK, Wilensky JT. Laseriridectomy in the management of chronic angle closure glaucoma. Am J Ophthalmol 1984; 98: 446–50.

    Google Scholar 

  10. Greve EL, Wagemans MJ. Reduction of intraocular pressure after extracapsular cataract extraction with posterior chamber intraocular lens implantation in patients with narrow angles. In: Greve EL, (ed) Surgical management of coexisting glaucoma and cataract. Amsterdam, Kugler publications 1987; 59–64.

    Google Scholar 

  11. Greve EL. Primary angle closure glaucoma: extracapsular cataract extraction or filtering procedure? Int Ophthalmol 1988; 12: 157–62.

    Google Scholar 

  12. Gunning FP, Greve EL. Clinical comparison of posterior capsular opacification in patients with a rigid Galand disc IOL in one eye and a Sinskey style J-loop IOL in the contralateral eye. To be published.

  13. Gunning FP, Greve EL. Intercapsular cataract extraction with implantation of the Galand disc lens: a retrospective analysis on patients with and without glaucoma. To be published.

  14. Hunsaker J, Kass MA. Combined procedures for cataract and glaucoma. Little, Brown and company, Boston. Int Ophthalmol Clin 1984; 24(3): 33–42.

    Google Scholar 

  15. Jaffe et al. Current concepts in posterior chamber lens technology. Am Intraocular Implant Soc J 1985;11: 456–60.

    Google Scholar 

  16. Kolker AE. Visual prognosis in advanced glaucoma: a comparison of medical and surgical therapy for retention of vision in 101 eyes with advanced glaucoma. Tr Am Ophthalmol Soc 1977; 75: 539–55.

    Google Scholar 

  17. Kraff MC. Implant loops: in or out of the capsular bag? In: Stark WJ, Tery AC, Maumenee AE (eds) Anterior segment surgery, Wiliams & Wilkins, Baltimore. 1987; pp 153–9.

    Google Scholar 

  18. Layden WE. Cataract and Glaucoma. In: Duane TD (ed) Clinical Ophthalmology, Philadelphia Harper and Rows publishers. 3, Ch 55, p 6.

  19. Lichter PR, Ravin JG. Risks of sudden visual loss after glaucoma surgery. Am J Ophthalmol 1974; 78(6): 1009–13.

    Google Scholar 

  20. Mc Cartney DL, Memmen JE, Stark WJ, Quigley HA et al. The efficacy and safety of combined trabeculectomy, cataract extraction and intraocular lens implantation in glaucomatous eyes. Ophthalmol 1988; 95: 754–63.

    Google Scholar 

  21. Mc Guigan LJB, Gottsch J, Stark WJ, Maumenee AE et al. Extracapsular cataract extraction and posterior lens implantation in eyes with preexisting glaucoma. Arch Ophthalmol 1986; 104: 1301–08.

    Google Scholar 

  22. Obstbaum SA. Glaucoma and intraocular lens implantation. J Cataract Refract Surg 1986; 12: 257–61.

    Google Scholar 

  23. Percival P. The glaucoma triple procedure. Dev Ophthalmol 1985; 11: 142–6.

    Google Scholar 

  24. Savage JA, Thomas JV, Belcher CD, Simons RJ. Extracapsular cataract extraction and posterior chamber intraocular lens implantation in glaucomatous eyes. Ophthalmology 1985; 92: 1506–16.

    Google Scholar 

  25. Shields MB. Combined cataract extraction and glaucoma surgery. Ophthalmology 1982; 89: 231–7.

    Google Scholar 

  26. Simmons ST, Litoff D, Nichols DA, Sherwood MB et al. Extracapsular cataract extraction and posterior chamber intraocular lens implantation combined with trabeculectomy in patients with glaucoma. Am J Ophthalmol 1987; 104: 465–70.

    Google Scholar 

  27. Smith JA. Glaucoma and intraocular lens implantation. In: Zimmerman TL, Monica ML (eds) Controversies in glaucoma. Little, Brown and company, Boston. Int Ophthalmol Clin 1984; 24(3): 33–42.

    Google Scholar 

  28. Smith R. Laser surgery in glaucoma. J R Soc Med 1984; 77: 175–7.

    Google Scholar 

  29. Van Oye R, Galand A, Budo C, Foets B et al. Two-year postoperative results of Galand lens implantation. J Cataract Refract Surg 1986; 12: 135–9.

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and permissions

About this article

Cite this article

Gunning, F.P., Greve, E.L. Uncontrolled primary angle closure glaucoma: results of early intercapsular cataract extraction and posterior chamber lens implantation. Int Ophthalmol 15, 237–247 (1991). https://doi.org/10.1007/BF00171026

Download citation

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF00171026

Key words

Navigation