Lens zonulopathy and primary angle closure glaucoma: what we know and what we don't know
Journal Title: Eye Science (Yanke Xuebao) - Year 2023, Vol 38, Issue 2
Abstract
Zonulopathy (including zonular laxity and dehiscence) can cause anterior displacement of iris-lens diaphragm, shallow anterior chamber, anterior chamber angle closure and elevated intraocular pressure, resulting in angle closure glaucoma (ACG). Idiopathic zonulopathy is common in primary angle closure glaucoma (PACG), which may be one of the pathogenic mechanisms of PACG. But further prospective cohort studies are needed to verify that. The proportion of diagnosis of zonulopathy in PACG patients before cataract extraction in combination with anti-glaucoma surgery is low by signs of anterior chamber depth differences between both eyes, iridodonesis / phacodonesis and UBM examination. Hence, most cases with zonulopathy in PACG are found during the operation, which is called occult zonulopathy. At present, the diagnosis of zonulopathy in PACG is often made according to the intraoperative manifestations, such as visible capsular equator after mydriasis, wrinkling of the anterior capsule during manual capsulorhexis, infolding of peripheral capsule or visualization of the capsular equator during the cortical or nuclear removal; loose or floppy capsular bag. According to diff erent ranges and severities of zonulopathy, phacoemulsification combined with intraocular lens (IOL) implantation, with or without capsule tension ring implantation, or sclera-fixated IOL is selected. PACG patients should be paid more attention to the diagnosis and diff erentiation of zonulopathy before and during operation, fully improved the preoperative examination, and formulated individualized treatment plans to ensure the safety and efficacy of operation.
Authors and Affiliations
Hui ZHANG, Ye ZHANG, Shuo ZHANG, Chunyan QIAO
Keywords
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- EP ID EP764607
- DOI 10.12419/j.issn.1000-4432.2023.02.10
- Views 10
- Downloads 0
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