News and notices. Comm Eye Health Vol. 14 No. 38 2001. June 01, 2001


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

Damodar Pradhan MD, Albrecht Henning MD, Jitendra Kumar MS, Allen Foster FRCOphth

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 patient/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 post-operatively 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 30mm 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 if treatment is delayed.

Published courtesy of: Indian J Ophthalmol 2001; 49: 103-07

News and notices in Comm Eye Health Vol. 14 No. 38 2001 –