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

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

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Purpose: To determine the frequency and types of lens-induced glaucoma (LIG), reasons for late presentation and outcome of current management.Methods: Prospective case series of 413 patients/eyes with LIG Star Dish 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.

Results: Four hundred and thirteen (1.5%) of 27,073 senile cataracts seen in the outpatient department of Sagarmatha Choudhary Eye Hospital, Lahan, Nepal presented with LIG.There were 298 (72%) phacomorphic cases and 115 (28%) phacolytic glaucoma.

Pain for more than 10 days was reported by 293 (71%) patients.The majority, 258 (62.4%), travelled a distance of more than 100 kms to the hospital.

The major reasons for late presentation were "no escort" in 143 (34.6%) and "lack of money" in 128 (31.0%) cases.

At presentation the IOP was more than 30 mm Hg in 327 (79%) eyes.Following cataract surgery, 251 (80.7%) 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%) achieved 6/60 or better, 97 (31.2%) less than 6/60, and 94 (30.

2%) less than 3/60.The main causes for poor outcome in 94 cases were optic atrophy in 32 (34%) eyes, uveitis in 25 (26.6%)eyes and corneal oedema in 24 (25.

5%) eyes.Conclusion: 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 Mailbox Bin if treatment is delayed.