Lens-Particle Glaucoma

Updated: Aug 13, 2015
  • Author: Brian R Sullivan, MD; Chief Editor: Hampton Roy, Sr, MD  more...
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Overview

Background

Lens-particle glaucoma, a subclassification of lens-induced glaucoma, [1, 2, 3, 4, 5] is a type of secondary open-angle glaucoma involving intraocular retention of fragmented lens debris. Following surgery or injury, lens material may be sequestered within the capsular bag or dislocated into other areas of either the posterior eye or the anterior eye. Characteristically, large lens pieces spontaneously fragment further into small (sometimes invisible) particles that eventually migrate into the anterior chamber and obstruct aqueous outflow. [6] Lens-particle glaucoma is not associated with decentration or dislocation of an intact lens.

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Pathophysiology

The mechanism involves the following 4 processes: (1) presence of a nonintact lens capsule, usually violated during trauma or intraocular surgery; (2) subsequent release of microscopic lens debris into the anterior chamber, sometimes associated with dislocation of larger lens fragments in the anterior or posterior segment; (3) obstruction of trabecular meshwork by lens particles [6] and inflammatory components [7] ; and (4) reduction of the outflow facility of an open anterior chamber angle, resulting in elevation of intraocular pressure (IOP).

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Epidemiology

Frequency

United States

The incidence of lens-particle glaucoma has not been specifically reported. The frequency of penetrating eye injury in the United States has been estimated at 3.1 per 100,000 person-years, [8] with a predominance of young males.

Mortality/Morbidity

Mortality is not associated with this condition. Morbidity is rare.

Race

No known racial predilection exists.

Sex

No known gender predilection exists for lens-particle glaucoma. However, penetrating eye trauma, a risk factor for lens-particle glaucoma, has been reported to occur more commonly in young adult males. [8] Alcohol abuse is a significant comorbidity in this population.

Age

All ages are affected, ranging from infancy (especially when involving congenital cataract surgery) to late adulthood. Penetrating eye injuries occur most frequently in young adults. However, lens-particle glaucoma probably occurs most commonly in elderly persons as a complication of cataract surgery.

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