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Recent Advances in Ophthalmology. 2014, (11) Core

Importance of mydriasis in diagnosis and treatment of secondary glaucoma due to lens subluxationChinese Full Text

DU Xiu-Juan;MA Xiao-Hua;TENG Zhao-E;LIU Zheng-Feng;BI Hong-Sheng;Affiliated Eye Hospital of Shandong University of Traditional Chinese Medicine;The Second Affiliated Hospital of Shandong University of Traditional Chinese Medicine;The People’s Hospital of Wulian;

Abstract: Objective To analyze the clinical characteristics in patients with secondary glaucoma due to atypical lens subluxation,analyze the importance of mydriasis in diagnosis and treatment,and find the safe and efficient treatment of these patients. Methods Twenty-five eyes of21 patients with secondary glaucoma due to lens subluxation were examined,different operation was performed according to the degree of zonular dialysis. The postoperative ocular pressure,visual acuity and complication were analyzed. Results The clinical characteristics of these 21 patients were very similar with primary acute angle closure glaucoma,but these 21 patients had tremor iris,seizure of anterior chamber depth（ 1. 17 ± 0. 48） mm,which was shallower than that of the fellow eye（ 2. 57 ± 0. 52） mm（ P ＜ 0. 05）. Anterior chamber depth was deeper after mydriasis（ 1.53 ±0.27） mm than before mydriasis（ P ＜0. 05）,and intraocular pressure decreased from（ 48.12 ±3.15） mmHg（ 1 kPa =7.5 mmHg） to（ 17.65 ±2.79） mmHg（ F =38.462,P ＜0.05）.UBM showed 16 eyes（ 64. 0%） with subluxated lens after mydriasis,24 eyes（ 96. 0%） showed lens subluxation. The rate of mydriasis in lens subluxation was higher than UBM. On postoperative6 months,the ocular pressure in 21 eyes（ 84. 0%） were normal,4 eyes（ 16. 0%） needed the drugs to control,which was（ 22. 74 ± 3. 15） mmHg,there was statistical difference compared with pre-operation（ F = 26. 547,P ＜ 0. 05）. At postoperative 2 years,except that ocular pressure in 1eye could not controlled by drugs,other 24 eyes was normal,which was（ 18. 95 ± 3. 74） mmHg,there was statistical difference compared with pre-operation（ F = 19. 938,P ＜ 0. 05）. Conclusion Secondary glaucoma due to subluxated lens is easily misdiagnosed as primary acute angle-closure glaucoma. To low the rate of misdiagnosis,we need the exact history and ocular examination.Mydriasis is important in diagnosis,and lens extraction is required in order to have satisfactory intraocular pressure in these patients.
Keywords：

mydriasis; atypical; lens dubluxation; secondary glaucoma; surgical treatment;

  • DOI：

    10.13389/j.cnki.rao.2014.0292

  • Series：

  • Subject：

  • Classification Code：

    R775

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