Management of Glaucoma Capsulare: Outcomes and Complications of Trabeculectomy

Purpose: To analyze the results of filtration surgery in cases of Glaucoma Capsulare. Study Design: Experimental study. Place and Duration: Al-Ibrahim Eye Hospital, Karachi, from January 2018 to December 2018. Methods: Forty eyes of forty patients, between 50 to 80 years of age, with Glaucoma Capsulare, not controlled with topical medication were included in the study. Patients not willing for filtration surgery and those who had any other ocular disease were excluded. Pre-operative examination, including visual acuity, retinoscopy, intra ocular pressure and fundus examination was done. Complete blood count, blood sugar and urine complete were also carried outto rule out any other illness. All collected data was analyzed through software SPSS version 20. Results: There were 26 (65.0%) males and 14 (35.0%) females. Mean age was 62.1 ± 12.44 years. Mean IOP was 34.0 ± 2.43 mm of Mercury. At first follow-up mean IOP (mm.Hg) was 11.44 ± 3.2 and at 12 weeks follow-up, the IOP was 10.14 ± 4.1. Angle 0 – I (closed angle) was seen in 6 (15.0%), Angle grade II – III (Open angle) was seen in 10 (25.0%) and grade III – IV (open angle) was seen in 24 (60.0%) patients. Visual acuity 6/9 were in 4 (10.0%), 6/12 – 6/18 in 10 (25.0%), 6/18 – 6/24 was in 12 (30.0%) and visual acuity 6/36 – 6/60 was noted in 14 (35.0%) patients. Early complications were flat anterior chamber in 4 (10%) and corneal edema in 4 (10%) patients. However late complications were hyphema and cataract in 2 (5%) and 25 (62.5%) patients respectively. Conclusion: Trabeculectomy significantly lowers the intraocular pressure in patients with Glaucoma Capsulare. Key Words: Glaucoma Capsulare, Trabeculectomy, Gonioscopy, Hyphema, Pseudoexfoliation glaucoma.

GLAUCOMA CAPSULARE

Purpose of Study: To emphasize the role of filtration surgery in the treatment of glaucoma capsulare. Moreover the studyalso highlights the importance of thorough ocular examination and diagnosis as the condition is likely to be missed. Material, M e t h o d s andResults: This study was conducted to find out the results of filtration surgery (trabeculectomy) in such cases. Forty cases with pseudoexfoliationglaucoma presenting in the Dept of Ophthalmology PAF Hospital Mushaf Sargodha were included. These patients were initially treated withtopical medications for three months. Thirty cases that showed poor response to drugs were operated upon and a trabeculectomy wasperformed. Postoperative pressure readings were recorded twice weekly for the first two months and then once monthly for four months. Aftera follow-up of six months, twenty five cases (83.33%) were effectively controlled without any added medications whereas five cases (16.67%)required addition of a single drug to achieve the desired effect. Conclusion: The response to medical treatment is generally not satisfactoryand surgery has to be undertaken as a final resort. Trabeculectomy is the safe and effective operation in glaucoma capsulare (pseudoexfoliationglaucoma).