Management of Spherophakia- or Microspherophakia-associated Mild to Moderate Glaucoma with Lensectomy, Anterior Vitrectomy, and Iris-Claw Intraocular Lens Implantation

TL;DR

This study shows that a specific eye surgery improves vision and lowers pressure in patients with spherophakia-related glaucoma.

Contribution

The study demonstrates the effectiveness of lensectomy and iris-claw lens implantation for treating glaucoma in spherophakia patients.

Findings

Visual acuity improved significantly after surgery.

Intraocular pressure decreased and fewer glaucoma medications were needed.

The procedure was effective in both isolated and syndromic microspherophakia cases.

Abstract

To report the outcomes of lensectomy, anterior vitrectomy, and iris-claw lens implantation in patients with spherophakia- or microspherophakia-related glaucoma.

In this retrospective case series, we focused on patients with isolated microspherophakia or microspherophakia associated with various syndromes and mild to moderate angle-closure glaucoma who had undergone lensectomy, anterior vitrectomy, and iris-claw lens implantation.

We analyzed a total of 12 eyes of 6 patients with a mean age of 19
±
6 years and a mean postoperative follow-up of 66
±
12 months. All patients had lenticular myopia, and the mean refraction improved from
-
7.26
±
0.67 diopters (D) to
-
1.18
±
1.04 D after surgery. The mean corrected visual acuity improved from 0.92
±
0.57 logMAR before surgery to 0.17
±
0.15 logMAR at the last follow-up (P = 0.001). The mean intraocular pressure (IOP) decreased from 21.2
±
3.9 mmHg on 1.9
±
0.7 anti-glaucoma medications at baseline to 15.0
±
1.5 mmHg (P = 0.006) on 0.8
±
0.7 medications (P = 0.006) at the last follow-up.

Lensectomy and iris-claw lens implantation in our cases not only decreased the IOP and reduced the number of glaucoma medications, but also improved the best-corrected visual acuity. Removal of the abnormally shaped lens likely contributed to these changes.

Figures