# 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.

## Key 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.