Results of antiglaucomatous cataract extraction in patients with relative anterior microphthalmus (RAM)
G.U. Auffarth, Y. Biazid, M.R Tetz, H.E. Völcker
Purpose: Patients with relative anterior microphthalmus (RAM) are characterized by corneal diameters <11mm and normal axial length. Those patients have often very shallow anterior chambers with a depth of <2mm, which consequently results in a high incidence of glaucoma. As the lens is relatively large for these smaller anterior segments cataract extraction is often the only means to reduce and control intraocular pressure (IOP).
Patients and methods: Twenty patients with RAM, aged 71.3 ± 12,0 years, were evaluated before and after cataract surgery in terms of IOP change, anterior chamber depth (ACD) and antiglaucomatous medication.
Results: IOP prior to cataract surgery under treatment of 2,7 ± 1,7 glaucoma medications was on average 19.3 ±8.3mmHg (Range: 10-45mmHg). Postoperatively there was a significant IOP reduction to 14.3 ± 3.0mmHg (Range: 9-20mmHg) with reduced medication (1.68).8) (p=0,04). ACD changed from 2.35 ± 0.55mm preoperatively to 3.66 ± 0.59mm postoperatively. One year after surgery IOP values remained stable (15.3 ± 3.0mmHg).
Conclusions: The special anatomical features of RAM are responsible for the high incidence of glaucoma and the problems of IOP regulation. Cataract extraction sometimes even as clear lens extraction is one of the most important procedures to assure IOP control.
Department of Ophthalmology, University of Heidelberg, INF 400, 69120 Heidelberg