Incidencia de glaucoma agudo por bloqueo pupilar tras implante de lente intraocular fáquica tipo icl. Resultados anatómicos y funcionales a corto, medio y largo plazo

Identifier:  TDX:2530

Handle: https://hdl.handle.net/20.500.11797/TDX2530

Authors:  Callizo Planas, Miquel

Abstract:
PURPOSE: to evaluate the incidence of acute angle-closure glaucoma due to pupillary block after phakic posterior chamber intraocular lens (ICL) implantation, as well as to determine the risk factors for developing such acute glaucoma and its consequences. METHODS: a retrospective and prospective clinical series study, where data from 633 eyes were collected from 348 patients undergoing ICL implantation from 2001 to 2010 at the Institut Català de Retina, with a minimum follow-up of 1 month and maximum of 5 years. They were divided into 2 study groups according to whether or not they had suffered an acute glaucoma. RESULTS: the incidence of acute glaucoma after ICL implantation due to pupillary block was 3.2% (95% CI: 1.8-4.5%). There were only intraocular pressure (IOP) differences between the two study groups at 6 and 24 hours, not beyond. Among the anatomical characteristics, there were only differences (p <0.05) between the 2 groups in the sulcus-sulcus distance. The appearance of atrophy of iris and/or atonic pupil were higher (p 0,000) in cases with acute glaucoma, but no higher incidence of cataracts. The variable with the highest power as a risk factor is the depth of the anterior chamber, although it is not statistically significant (p = 0.075). CONCLUSIONS: The incidence of acute angle-closure glaucoma due to pupillary block in our sample was similar to the published studies. Acute glaucoma due to pupillary block after ICL implantation appears between 6 and 72 hours after surgery, therefore controls are required in the immediate postoperative period. The anatomic and/or ICL-related factors that increase the risk of acute glaucoma are the depth of the anterior chamber and a positive disproportion between the ICL diameter and the sulcus-sulcus distance.