Intraocular lens position and anterior chamber angle changes after cataract extraction in eyes with primary angle-closure glaucoma

Abstract

Purpose: To prospectively study the anterior chamber angle in eyes with chronic primary angle-closure glaucoma (PACG) having posterior chamber intraocular lens (IOL) implantation and evaluate IOL position and intraocular pressure (IOP). Setting: National Taiwan University Hospital, Taipei, Taiwan. Methods: Using Scheimpflug image processing, the anterior chamber angles were studied in 20 consecutive eyes with chronic PACG and 10 control eyes before and after posterior chamber IOL implantation. Anterior chamber depth, chamber angle width, IOL position, and IOP change were evaluated. Results: Mean anterior chamber depth in the PACG group was 2.04 ± 0.29 mm preoperatively and 3.44 ± 0.16 mm postoperatively. The anterior chamber angle widened significantly in relation to the superior, inferior, temporal, and nasal quadrants after surgery. The degree of IOL tilting and decentration was the same in both the PACG and control groups. All eyes in the PACG group maintained an IOP under 21 mm Hg during the 6 month follow-up. Eighty-four percent maintained or decreased their antiglaucoma medication; 16% required increased medication. Conclusion: Cataract extraction with posterior chamber IOL implantation in eyes with PACG controlled IOP well in most cases.