Ординатура / Офтальмология / Английские материалы / Clinical Pathways in Glaucoma_Zimmerman, Kooner_2001

220 Glaucoma Associated with Lens Disorders

How Is Angle-Closure Glaucoma in Aphakia

and Pseudophakia Managed?

Only aspects specifically pertinent to the absence of the natural lens or the presence or an IOL are addressed in this section. The reader is referred to specific chapters when a more general approach is indicated.

The initial management of ACG regardless of the mechanisms involved depends on the level of IOP and status of the eye. In acute symptomatic cases, hyperosmotics and aqueous suppressants are indicated. Once the IOP has been lowered and the eye is quiet, any subsequent treatments have a greater chance of succeeding.

If an open PI is not present and an iris bombé configuration strongly suggests pupillary block, the treatment of choice is an Nd:YAG laser peripheral iridotomy. More than one may be needed if posterior synechiae have created loculated pockets of fluid behind the iris. Once the pupillary block has been, overcome the next issue is whether or not PAS is present. If the treatment is prompt, PAS may be prevented. Glaucoma filtering surgery may be necessary if the synechiae persist and less invasive procedures such as peripheral iridoplasty have not been effective. See Chapter 5 for a complete discussion on the treatment of acute and chronic secondary angle-closure glaucoma.

If a typical iris-bombé configuration is not present, or if doing the PI does not change the configuration of the anterior chamber, the possibility of aqueous misdirection should be raised. Of course, if an open PI was present on presentation, this would be the first diagnostic suspicion in a patient with a shallow anterior chamber and elevated IOP. See Chapters 12 and 19 for a complete discussion on malignant glaucoma.

Future Considerations

As practice patterns continue to evolve29 glaucoma in aphakia will become a rarity. The management of this entity will vary as new drugs and surgical techniques appear. Glaucoma in pseudophakia, on the other hand, may continue to be a challenge. Prevention through improved surgical techniques and early detection are essential to ensure a good visual outcome.

References

1.Shields BM: Glaucomas associated with disorders of the lens. In: Ritch R, Shields MB, Krupin T (eds): Textbook of glaucoma, 4th ed. Baltimore: Williams & Wilkins, 1998;153–176.

2.Ritch R, Shields BM (eds). The secondary glaucomas. St. Louis: CV Mosby, 1982.

3.Hein HF, Maltzman B: Long-standing anterior dislocation of the crystalline lens. Ann Ophthalmol 1975;7:66–68.

4.Liebmann JM, Ritch R: Glaucoma associated with lens intumescence and dislocation. In: Ritch R, Shields MB, Krupin T (eds): The glaucomas, vol. 2, 2d ed. St. Louis: Mosby-Year Book, 1996;1033–1053.

5.Nelson LB, Maumenee IH: Ectopia lentis. Surv Ophthalmol 1982;27:143–160.

6.Goldberg MF: Clinical manifestations of ectopia lentis et pupillae in 16 patients. Ophthalmology 1988;95:1080–1087.

7.Luebbers JA, Goldbert MF, Herbst R, et al: Iris transillumination and variable expression in ectopia lentis et pupillae. Am J Ophthalmol 1977;83:647–656.

8.Lonnqvist L, Child A, Kainulanem K, et al: A novel mutation of the fibrillin gene causing ectopia lentis. Genomics 1994;19:573–576.

9.Seland JH: The lenticular attachment of the zonular apparatus in congenital simple ectopia lentis. Acta Ophthalmol 1973;51:520–528.

10.McCulloch C: Hereditary lens dislocation with angle-closure glaucoma. Can J Ophthalmol 1979;14:230–234.

11.Johnson VP, Grayson M, Christian JC: Dominant microspherophakia. Arch Ophthalmol 1971;85:534–537.

12.Jensen AD, Cross HE, Paton D: Ocular complications in the Weill-Marchesani syndrome. Am J Ophthalmol 1974;77:261–269.

13.Cross HE, Jensen AD: Ocular manifestations in the Marfan syndrome and homocystinuria. Am J Ophthalmol 1973;75:405–420.

14.Willi M, Kut L, Cotlier E: Pupillary-block glaucoma in the Marchesani syndrome. Arch Ophthalmol 1973;90:504-508.

15.Wright KW, Chrousos GA: Weill-Marchesani syndrome with bilateral angle-closure glaucoma. J Ped Ophthalmol Strabismus 1985;22:129–132.

16.Feiler-Ofry V, Stein R, Godel V: Marchesani’s syndrome and chamber angle anomalies. Am J Ophthalmol 1968;66:862–886.

17.Kiety CM, Shuttleworth CA: Abnormal fibrillin assembly by dermal fibroblasts from two patients with Marfan syndrome. J Cell Biol 1994;124:997–1004.

18.Tsipouras P, Del Mastro R, Sarfarazi M: The international Marfan genetic linkage study: genetic linkage of the Marfan syndrome, ectopia lentis, and congenital contractural arachnodactyly to the fibrillin genes on chromosomes 15 and 5. N Engl J Med 1992;326:905–909.

19.Maumenee IH: The eye in the Marfan syndrome. Trans Am Ophthalmol Soc 1981;79:684–733.

20.Izquierdo NJ, Traboulsi EI, Enger C, et al: Glaucoma in the Marfan syndrome. Trans Am Ophthalmol Soc 1992;90:111–117.

21.Von Noorden GK, Schultz RO: A gonioscopic study of the chamber angle in Marfan’s syndrome. Arch Ophthalmol 1960;64:929–934.

22.Harrison DA, Mullaney PB, Mesfer SA, et al: Management of ophthalmic complications of homocystinuria. Ophthalmology 1998;105:1886–1890.

23.Ritch R, Solomon LD: Argon laser peripheral iridoplasty for angle-closure glaucoma in siblings with Weill-Marchesani syndrome. J Glaucoma 1992;1:243.

24.Epstein DL: Glaucoma associated with congenital and spontaneous dislocations of the lens. In: Epstein DL (ed): Chandler & Grant’s glaucoma, 3d ed. Philadelphia: Lea & Febiger, 1986;316–319.

25.Girard LJ, Canizales R, Esnaola N: Subluxated (ectopic) lenses in adults. Long-term results of pars plana lensectomy-vitrectomy by ultrasonic fragmentation with and without a phacoprosthesis. Ophthalmology 1990;97:462–465.

26.Plager DA, Parks MM, Helveston EM: Surgical treatment of subluxated lenses in children. Ophthalmology 1992;99:1018–1021.

27.Klein BEK, Klein R, Linton KLP: Prevalence of age-related lens opacities in a population: the Beaver Dam Eye Study. Ophthalmology 1992;99:546–552.

28.Klein BEK, Klein R, Sponsel WE, et al: Prevalence of glaucoma: the Beaver Dam Eye Study. Ophthalmology 1992;99: 1499–1504.

29.Schein OD, Steinberg EP, Javitt JC, et al: Variation in cataract surgery practice and clinical outcomes. Ophthalmology 1994;101:1142–1152.

30.Richter CU: Lens induced open-angle glaucoma. In: Ritch R, Shields MB, Krupin T (eds): The glaucomas, vol. 2, 2d ed. St. Louis: Mosby-Year Book, 1996;1023–1031.

31.Epstein DL: Diagnosis and management of lens-induced glaucoma. Ophthalmology 1982;89: 227–230.

32.Richter CU, Arzeno G, Pappas HR: Intraocular pressure elevation following Nd:YAG laser posterior capsulotomy. Ophthalmology 1985;92:636–640.

33.Smith CB: Effect of neodymium:YAG laser posterior capsulotomy on outflow facility. Glaucoma 1984;6:171.

34.Schubert HD, Morris WJ, Trokel SL: The role of the vitreous in the intraocular pressure rise after neodymium:YAG laser capsulotomy. Arch Ophthalmol 1985;103:1538–1542.

35.Epstein DL: Lens-induced glaucoma. In: Epstein DL (ed): Chandler and Grant’s glaucoma, 4th ed. Baltimore: Williams & Wilkins, 1997;422–430.

36.Tomita G, Watanabe K, Funahashi M, et al: Lens-induced glaucoma: histopathological study of the filtrating angle. Folia Ophthalmol Jpn 1984;35:1345–1350.

37.Epstein DL: Lens-induced glaucoma (phacolytic glaucoma). In: Fraunfelder FT, Roy FH (eds): Current ocular therapy, vol. 4. Philadelphia: WB Saunders, 1995;643–644.

38.Brooks AM, Grant G, Gillies WE: Comparison of specular microscopy and examination of aspirate in phacolytic glaucoma. Ophthalmology 1990;97(1):85–89.

39.Mandal AK, Gothwal VK: Intraocular presure control and visual outcome in patients with phacolytic glaucoma managed by extracapsular cataract extraction with or without posterior chamber intraocular lens implantation. Ophthalmol Surg Lasers 1998;29(11):880–889.

222 Glaucoma Associated with Lens Disorders

40.Lane SS, Kopietz LA, Lindquist TD, et al: Treatment of phacolytic glaucoma with extracapsular cataract extraction. Ophthalmology 1988;95:749–753.

41.Prajna NV, Ramakrishnan R, Krishnadas R, et al: Lens induced glaucomas—visual results and risk factors for final visual acuity. Indian J Ophthalmol 1996;44(3):149–155.

42.Gressel MG: Lens-induced glaucoma. In: Tasman W, Jaeger EA (eds): Duane’s clinical ophthalmology, vol. 3, Lippincott-Raven, Philadelphia:1998;1–9.

43.Markowitz SN, Morin JD: The ratio of lens thickness to axial length for biometric standardization in angle-closure glaucoma. Am J Ophthalmol 1985;99:400–402.

44.Pavlin CJ, Foster FS: Ultrasound biomicroscopy in glaucoma. In: Ritch R, Shields MB, Krupin T (eds): The glaucomas, vol. 1, 2d ed. St. Louis: Mosby-Year Book, 1996;471–490.

45.Al-Torbak A, Karcioglu ZA, Abboud E, et al: Phacomorphic glaucoma associated with choroidal melanoma. Ophthalmic Surg Lasers. 1998;29(6):510–513.

46.Tomey KF, Al-Rajhi AA: Neodymium: YAG laser iridotomy in the initial management of phacomorphic glaucoma. Ophthalmology 1992;99:660-665.

47.Ritch R, Solomon IS: Glaucoma surgery. In: L’Esperance FA (ed): Ophthalmic lasers, 3d ed. St. Louis Mosby-Year Book, 1989;650–690.

48.Rao SK, Padmanabhan P: Capsulorhexis in eyes with phacomorphic glaucoma. J Cataract Refrac Surg 1998;24(7):882-884.

49.Ritch R: Exfoliation syndrome. In: Ritch R, Shields MB, Krupin T (eds): The glaucomas, vol. 2, 2d ed. St. Louis: Mosby-Year Book 1996;993–1022.

50.Streeten BW, Dark AJ. Pseudoexfoliation syndrome. In: Garner A, Klintworth GK (eds): Pathobiology of ocular disease: a dynamic approach, 2d ed. New York: Dekker, 1994;591–629.

51.Forsius H: Exfoliation syndrome in various ethnic populations. Acta Ophthalmol Suppl 1998;184:71–85.

52.Masanganise R: Pseudo-exfoliation syndrome in Chivi District: a disease with no geographical or racial boundaries. Cen Afr J Medicine 1997;43(8):229–231.

53.Jones W, White RE, Magnus DE: Increased occurrence of exfoliation in the male, Spanish American population of New Mexico. J Am Optom Assoc 1992;63(9):643–648.

54.Iizuka S, Nakae R, Motokura M: Incidence of pseudoexfoliation syndrome. Folia Ophthalmol Jpn 1991;42:926–930.

55.Liebowitz HM, Krueger DE, Maunder LR: The Framingham Eye Study monograph. Surv Ophthalmol 1980;24 (suppl):335–610.

56.Yalaz M, Othman I, Nas K, et al : The frequency of pseudoexfoliation syndrome in the eastern Mediterranean area of Turkey. Acta Ophthalmol 1992;70(2):209–213.

57.Roth YB, Epstein DL: Exfoliation syndrome. Am J Ophthalmol 1980;89:700–707.

58.Faulkner HW: Pseudoexfoliation of the lens among the Navajo Indians. Am J Ophthalmol 1971;72:206–207.

59.Rouhiainen H, Terasvirta M: Presence of pseudoexfoliation on clear and opacified crystalline lenses in an aged population. Ophthalmologica 1992;204(2):67–70.

60.Hiller R, Sperduto RD, Krueger DE: Pseudoexfoliation, intraocular pressure, and senile changes in a population-based survey. Arch Ophthalmol 1982;100:1080–1082.

61.Cashwell LF, Shields MB: Exfoliation syndrome: prevalence in a southeastern United States population. Arch Ophthalmol 1988;106:335–336.

62.Kozart DM, Yannoff M: Intraocular pressure status in 100 consecutive patients with exfoliation syndrome. Ophthalmology 1982;89:214–218.

63.Aasved H: Study of relatives of persons with fibrillopathia epitheliocapsularis (pseudoexfoliation of the lens capsule). Acta Ophthalmol 1975;53:79–86.

64.Konstas AG, Ritch R, Bufidis T, et al: Exfoliation syndrome in a 17-year-old girl. Arch Ophthalmol 1997;115(8):1063-1067.

65.Horns DJ, Bellows AR, Hutchinson BT: Argon laser trabeculoplasty for open-angle glaucoma: a retrospective study of 380 eyes. Trans Ophthalmol Soc 1983;103:288–296.

66.Roth M, Epstein DL: Exfoliation syndrome. Am J Ophthalmol 1980;89:477–481.

67.Luntz MH: Prevalence of pseudoexfoliation syndrome in an urban South African clinic population. Am J Ophthalmol 1972;74:581–587.

68.Lindblom B, Thorburn W: Observed incidence of glaucoma in Halsingland, Sweden. Acta Ophthalmol 1984;62:217–222.

69.Moreno-Montanes, Alvarez Serna A, Alcolea Paredes A: Pseudoexfoliative glaucoma in patients with open-angle glaucoma in the northwest of Spain. Acta Ophthalmol 1990;68(6):695–699.

70.Davanger M, Ringvold A, Blika S: The frequency distribution of the glaucoma tolerance limit. Acta Ophthalmol 1991;69(6):782–785.

71.Ekstrom C: Elevated intraocular pressure and pseudoexfoliation of Thelen’s capsule as risk factors for chronic open-angle glaucoma: a population-based 5-year follow-up study. Acta Ophthalmol 1993;71:189–195.

72.Drolsum L, Haaskjold E, Davanger M: Pseudoexfoliation syndrome and extracapsular cataract extraction. Acta Ophthalmol 1993;71:765–770.

73.Davanger M, Ringvold A, Blika S: Pseudo-exfoliation, IOP and glaucoma. Acta Ophthalmol 199;69(5):569–573.

74.Slagsvold JE: The follow-up in patients with pseudoexfoliation of the lens capsule with and without glaucoma. II. The development of glaucoma in persons with pseudoexfoliation. Acta Ophthalmol 1986;64:241–245.

75.Prince AM, Ritch R: Clinical signs of the pseudoexfoliation syndrome. Ophthalmology 1986;93:803–807.

76.Prince AM, Streeten BW, Ritch R, et al: Preclinical diagnosis of pseudoexfoliation syndrome. Arch Ophthalmol 1987;105:1076–1082.

77.Speakman JS, Ghosh M: The conjunctiva in senile lens exfoliation. Arch Ophthalmol 1976;94: 1757–1759.

78.Colin J, Mader P, Volant A: The prevalence of exfoliation syndrome in different areas of France. Acta Ophthalmol Suppl 1988;66:86–89.

79.Madden JG, Crowley MJ: Factors in the exfoliation syndrome. Br J Ophthalmol 1982;66:432–437.

80.Crittendon JJ, Shields MB: Exfoliation syndrome in the southern United States. II. Characteristics of patient population and clinical course. Acta Ophthalmol Suppl 1988;66:103–106.

81.Naumann GOH, Schlotzer-Schrehardt U, Kucle M: Pseudoexfoliation syndrome for the comprehensive ophthalmologist. Ophthalmology 1998;105:951–968.

82.Sugar HS, Harding C, Barsky D: The exfoliation syndrome. Ann Ophthalmol 1976;8:1165–1181.

83.Caccamise WC: The exfoliation syndrome in the aphakic eye. Am J Ophthalmol 1981;91:111–112.

84.Ringvold A, Bore J: Pseudoexfoliation syndrome pattern on posterior intraocular lens. Acta Ophthalmol 1990;68:353–355.

85.Garner A, Alexander RA: Pseudoexfoliative disease: histochemical evidence of an affinity with zonular fibers. Br J Ophthalmol 1984;68:574–580.

86.Zetterstrom C, Olivestedt G, Lundvall A: Exfoliation syndrome and extracapsular cataract extraction with implantation of posterior chamber lens. Acta Ophthalmol 1992;70:85–90.

87.Repo LP, Terasvirta ME, Tuovinen EJ: Generalized peripheral iris transluminance in the pseudoexfoliation syndrome. Ophthalmology 1990;97(8):1027–1029.

88.Konstas AG, Marshal GE, Cameron SA, et al: Morphology of iris vasculopathy in exfoliation glaucoma. Acta Ophthalmol 1993;71:751–759.

89.Davanger M: On the ultrastructure and the formation of pseudoexfoliation material. Acta Ophthalmol 1977;55:621–633.

90.Skuta GL: Pseudoexfoliation syndrome, pigment dispersion syndrome, and the associated glaucomas. In: Tasman W, Jaeger AE (eds): Duane’s clinical ophthalmology, vol 3. Philadelphia: Lippincott-Raven, 1996;1–10.

91.Brooks AMV, Gillies WE: The presentation and prognosis of glaucoma in pseudoexfoliation of the lens capsule. Ophthalmology 1988;95:271–276.

92.Schlotzer-Schrehardt U, Naumann GO: Trabecular meshwork in pseudoexfoliation syndrome with and without open-angle glaucoma. A morphometric, ultrastructural study. Invest Ophthalmol Vis Sci 1995;36(9):1750–1764.

93.Gilies WE, Brooks AM: The presentation of acute glaucoma in pseudoexfoliation of the lens capsule. Aus N Z J Ophthalmol 1988;16(2):101–106.

94.Gross FJ, Tingey D, Epstein DL: Increased prevalence of occludable angles and angle-closure glaucoma in patients with pseudoexfoliation. Am J Ophthalmol 1994;117:333–336.

95.Franks WA, Miller MH, Hitchings RA, et al: Secondary angle closure in association with pseudoexfoliation of the lens capsule. Acta Ophthalmol 1990;68(3):350–352.

96.Bartholomew RS: Pseudoexfoliation and angle-closure glaucoma. Glaucoma 1981;3:213–217.

97.Von der Lippe I, Kuchle M, Naumann GO: Pseudoexfoliation syndrome as a risk factor for acute ciliary block angle closure glaucoma. Acta Ophthalmol 1993;71(2):277–279.

98.Mapstone R: Pigment release. Br J Ophthalmol 1981;65:258–263.

99.Netland PA, Ye H, Streeten BW, et al: Elastosis of the lamina cribrosa in pseudoexfoliation syndrome with glaucoma. Ophthalmology 1995;102(6):878–886.

100.Kuchle M, Schlotzer-Schrehardt U, Naumann GOH: Occurrence of pseudoexfoliative material in parabulbar structures in pseudoexfoliation syndrome. Acta Ophthalmol 1991;69:124–130.

101.Streeten BW, Li ZY, Wallace RN: Pseudoexfoliative fibrillopathy in visceral organs of a patient with pseudoexfoliation syndrome. Arch Ophthamol 1992;110:1757–1762.

102.Schlotzer-Schrehardt UM, Koca MR, Naumann GO, et al: Pseudoexfoliation syndrome: ocular manifestation of a systemic disorder? Arch Ophthalmol 1992;110:1752–1756.

103.Bergea B, Bodin L, Svedbergh B: Primary ALT vs pilocarpine. II. Long-term effects on intraocular pressure and facility of outflow: study design and additional therapy. Acta Ophthalmol 1994;72:145–154.

104.Brinchmann-Hansen O, Albrektensen T, Anmakrud N: Pilocarpine drops do not reduce intraocular pressure sufficiently in pseudoexfoliation glaucoma. Eye 1993; 7(pt 4):511–516.

105.Konstas AG, Jay JL, Marshall GE, et al: Prevalence, diagnostic features, and response to trabeculectomy in exfoliation glaucoma. Ophthalmology 1993;100(5):619–627.

224 Glaucoma Associated with Lens Disorders

106.Konstas AG, Stewart WC, Stroman GA, et al: Clinical presentation and initial treatment patterns in patients with exfoliation glaucoma versus primary open-angle glaucoma. Ophthalmic Surg & Lasers 1997;28(2):111–117.

107.Konstas AG, Mantziris DA, Cate EA, et al: Effect of timolol on the diurnal intraocular pressure in exfoliation and primary open-angle glaucoma. Arch Ophthalmol 1997;115(8):975–839.

108.Higginbotham EJ, Richardson TM: Response of exfoliation glaucoma to laser trabeculoplasty. Br J Ophthalmol 1986;70:837–839.

109.Threlkeld AB, Hertzmark E, Sturm RT, et al: Comparative study of the efficacy of argon laser trabeculoplasty for exfoliation and primary open-angle glaucoma. J Glaucoma 1996; 5(5):311–316.

110.Tuulonen A, Airaksinen PJ: Laser trabeculoplasty in simple and capsular glaucoma. Acta Ophthalmol 1983;61:1009.

111.Kuchle M, Nguyen NX, Hannappel E, et al: The blood-aqueous barrier in eyes with pseudoexfoliation syndrome. Ophthalmic Res 1995;27(suppl 1):136–142.

112.Wada Y, Nakatsu A, Kondo T: Long-term results of trabeculotomy ab externo. Ophthalmic Surg 1994;25(5):317–320.

113.Tanihara H, Negi A, Akimoto M, et al: Surgical effects of trabeculectomy ab externo on adult eyes with primary open angle glaucoma and pseudoexfoliation syndrome. Arch Ophthalmol 1993;111(12):1653–1661.

114.Tarkkanen A, Hietanen J: The impact of exfoliation syndrome on therapeutic efficacy in openangle glaucoma. Curr Opin Ophthalmol 1995;6:10–14.

115.Jacobi PC, Krieglstein GK: Trabecular aspiration: clinical results of a new surgical approach to improve trabecular facility in glaucoma capsulare. Ophthalmic Surg 1994;25:641–645.

116.Jacobi PC, Kietlein TS, Krieglstein K: Bimanual trabecular aspiration in pseudoexfoliation glaucoma. Ophthalmology 1998;105: 886–894.

117.Shields MB: Glaucomas in aphakia or pseudophakia. In: Shields MB (ed): Textbook of glaucoma, 4th ed. Baltimore: Williams & Wilkins, 1998; 350–357.

118.Tomey KR, Traverso CE: The glaucomas in aphakia and pseudophakia. Surv Ophthalmol 1991;36:79–112.

119.Schulze RR, Duke B Jr: Causes of enucleation following cataract extraction. Arch Ophthalmol 1965;73:74–80.

120.David R, Tessler Z, Yagev R, et al: Persistently raised intraocular pressure following extracapsular cataract extraction. Br J Ophthalmol 1990;74: 272–274.

121.Kooner KS, Dulaney DD, Zimmerman TJ: Intraocular pressure following extracapsular cataract extraction and posterior chamber intraocular lens implantation. Ophthalmic Surg 1988;19:471–474.

122.Hansen MH, Gyldenkerne GJ, Otland NW, et al: Intraocular presure seven years after extracapsular cataract extraction and sulcus implantation of a posterior chamber intraocular lens. J Cataract Refract Surg 1995;21:676–678.

123.Grajewski AL: Glaucoma in aphakia and pseudophakia. In: Tassman W, Jaeger EA (eds): Duane’s clinical ophthalmology, vol. 3. Philadelphia: Lippincott-Raven, 1996; 1–13.

124.Gross JG, Meyer DR, Robin AL: Increased intraocular pressure in the immediate postoperative period after extracapsular cataract extraction. Am J Ophthalmol 1988;105: 466–469.

125.Tomey KF, Traverso CE: Glaucoma associated with aphakia and pseudophakia. In: Ritch R, Shields MB, Krupin T (eds): The glaucomas, vol. 2, 2d ed. St. Louis: Mosby-Year Book, 1996; 1289–1323.

126.Kraff MC, Sanders DR, Lieberman HL: Intraocular pressure and the corneal endothelium after neodymium:YAG laser posterior capsulotomy: relative effects of aphakia and pseudophakia. Arch Ophthalmol 1985;103:511–514.

127.Layden WE: Glaucomas and intraocular lens implantation. In: Ritch R, Shields MB (eds): The secondary glaucomas. St Louis: Mosby-Year Book, 1982;367–380.

128.Moses L: Complications of rigid anterior chamber implants. Ophthalmology 1984;91:819–825.

129.Cohen JS, Osher RH, Weber P, et al: Complications of extracapsular cataract surgery: the indications and risks of peripheral iridectomy. Ophthalmology 1984;91:826–830.

130.Samples J, et al: Pupillary block with posterior chamber intraocular lenses. Am J Ophthalmol 1987;105:335–337.

131.Wellis DA, Stewart RH, Kimbrough RL: Pupillary block associated with posterior chamber lenses. Ophthalmic Surg 1985;16:108–109.

132.Ruderman JM, Mitchell PG, Kraff M: Pupillary block following Nd:YAG laser capsulotomy. Ophthalmic Surg 1983;14:418–419.

133.Rao NA: Lens-induced uveitis. In: Tassman W, Jaeger AE (eds): Duane’s clinical ophthalmology, vol. 4. Philadelphia: Lippincott-Raven, 1996;1–6.

134.Epstein DL: Lens-induced glaucoma. In: Chandler & Grant’s glaucoma, 4th ed. Baltimore: Williams & Wilkins, 1997;429.

135.Marak GE, Font RL, Rao NA: Abrogation of tolerance to lens protein. I. Effects of lipopolysaccaride. Ophthalmic Res 1979;11:192–195.

136.Apple DJ, Mamalis N, Steinmetz RL: Phacoanaphylactic endophthalmitis associated with extracapsular cataract extraction and posterior chamber intraocular lens. Arch Ophthalmol 1984;102:1528–1532.

137.Thomas JV, Gragoudas ES, Blair NP, et al: Correlation of epinephrine use and macular edema in aphakic glaucomatous eyes. Arch Ophthalmol 1978;96:625–628.

138.Herschler J: Medically uncontrolled glaucoma in the aphakic eye. Editorial. Ann Ophthalmol 1981;13:909.

139.Gross RL, Feldman RM, Spaeth GL: Surgical therapy of chronic glaucoma in aphakia and pseudophakia. Ophthalmology 1988;95;1195–1201.

140.Skuta GL, Parrish RK II: Wound healing in glaucoma filtering surgery. Surv Ophthalmol 1987;32:149–170.

This page intentionally left blank

RETINAL VASCULAR DISEASES

Definition

What Retinal Vascular Diseases Are Commonly

Associated with Glaucoma?

Excluding postoperative glaucoma, retinal vascular diseases represent the most common causes of secondary glaucoma. Ischemic retinovascular diseases give rise to glaucoma through different mechanisms leading to angle closure from neovascularization of the anterior segment, ciliary body rotation, and contracture of retrolenticular tissue. These diseases include each of the six retinal vascular diseases listed in Table 11–1. In addition, open-angle glaucoma can arise in the absence of angle neovascularization in patients with retinopathy of prematurity, diabetes mellitus, and retinal venous occlusions (Table 11–2).

Epidemiology and Importance

How Common Is Glaucoma in Association with the Retinal Vein Occlusion?

Several studies have clearly demonstrated that the incidence of primary openangle glaucoma (POAG) in patients with central retinal vein occlusion (CRVO) is much higher than in the normal population.1 Between 10 and 50% of patients with CRVO have been found to have an open-angle glaucoma.2,3

The frequency of secondary nonrubeotic angle-closure glaucoma after CRVO is unknown, although a few cases have been reported. Possibly this condition is rarely diagnosed rather than rare.4

Table 11–2. Retinal Vascular Diseases

Retinal venous occlusions

Branch retinal vein occlusion (BRVO)

Hemiretinal vein occlusion (HRVO)

Central retinal vein occlusion (CRVO)

Retinal arterial occlusions

Central retinal artery occlusion (CRAO)

Ophthalmic artery occlusion

Carotid occlusive disease

Proliferative diabetic retinopathy (PDR)

Retinopathy of prematurity (ROP)

Coats’ disease

Other retinal and choroidal vascular diseases

Choroidal hemorrhage

Choroidal hemangioma

Sturge-Weber syndrome

Sickle cell retinopathy

Syphilitic retinal vasculitis

Radiation retinopathy