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Phacolytic Glaucoma Follow-up

  • Author: Kayoung Yi, MD, PhD; Chief Editor: Hampton Roy, Sr, MD  more...
 
Updated: Apr 07, 2015
 

Further Outpatient Care

In most cases, IOP begins to rapidly normalize following cataract extraction, allowing discontinuation of ocular medications. A minority of patients will have persistent elevation of IOP requiring long-term medical therapy or filtering surgery to control the glaucoma.

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Further Inpatient Care

Inpatient care is not usually necessary for phacolytic glaucoma unless the patient is briefly hospitalized following emergency cataract extraction.

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Deterrence/Prevention

Removal of mature or hypermature cataracts may be preventive.

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Complications

Potential complications of phacolytic glaucoma include the following:

  • Loss of vision from uncontrolled glaucoma and/or persistent corneal edema
  • Surgical complications, including suprachoroidal hemorrhage, capsular rupture with loss of lens material into the posterior segment, corneal injury, and vitreous prolapse
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Prognosis

Prognosis is excellent, with most patients experiencing marked improvement in vision following cataract extraction; however, delayed treatment may cause a poor outcome.

Patients with phacolytic glaucoma (PG) may have a worse prognosis than patients with phacomorphic glaucoma.

In most cases, treatment to lower intraocular pressure can be discontinued after cataract extraction. A minority of patients who have persistent intraocular pressure elevation may need long-term medical therapy or a filtering surgery to control intraocular pressure.

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Patient Education

Seek a comprehensive eye examination when progressive vision loss is first noted.

For excellent patient education resources, visit eMedicineHealth's Eye and Vision Center. Also, see eMedicineHealth's patient education articles Glaucoma Overview, Glaucoma FAQs, and Glaucoma Medications.

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Contributor Information and Disclosures
Author

Kayoung Yi, MD, PhD Associate Professor, Department of Ophthalmology, Hallym University, Kangnam Sacred Heart Hospital, Korea

Kayoung Yi, MD, PhD is a member of the following medical societies: Korean Medical Association, Korean Ophthalmological Society, Korean Board of Ophthalmology

Disclosure: Nothing to disclose.

Coauthor(s)

Teresa C Chen, MD, FACS Associate Professor, Department of Ophthalmology, Harvard Medical School; Director of Clinical Affairs, Glaucoma Service, Consulting Staff, Department of Ophthalmology, Massachusetts Eye and Ear Infirmary

Teresa C Chen, MD, FACS is a member of the following medical societies: Alpha Omega Alpha, American Academy of Ophthalmology, American College of Surgeons, American Medical Association, Association for Research in Vision and Ophthalmology, Massachusetts Medical Society, Women in Ophthalmology, Inc

Disclosure: Nothing to disclose.

Specialty Editor Board

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Received salary from Medscape for employment. for: Medscape.

Martin B Wax, MD Professor, Department of Ophthalmology, University of Texas Southwestern Medical School; Vice President, Research and Development, Head, Ophthalmology Discovery Research and Preclinical Sciences, Alcon Laboratories, Inc

Martin B Wax, MD is a member of the following medical societies: American Academy of Ophthalmology, American Glaucoma Society, Society for Neuroscience

Disclosure: Nothing to disclose.

Chief Editor

Hampton Roy, Sr, MD Associate Clinical Professor, Department of Ophthalmology, University of Arkansas for Medical Sciences

Hampton Roy, Sr, MD is a member of the following medical societies: American Academy of Ophthalmology, American College of Surgeons, Pan-American Association of Ophthalmology

Disclosure: Nothing to disclose.

Additional Contributors

Richard W Allinson, MD Associate Professor, Department of Ophthalmology, Texas A&M University Health Science Center; Senior Staff Ophthalmologist, Scott and White Clinic

Richard W Allinson, MD is a member of the following medical societies: American Academy of Ophthalmology, American Medical Association, Texas Medical Association

Disclosure: Nothing to disclose.

References
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  3. Stamper R, Lieberman M, Drake M. Secondary open-angle glaucoma: phacolytic glaucoma. Becker-Shaffer's Diagnosis and Therapy of the Glaucomas. 7th ed. St Louis, Mo: Mosby; 1999. 324-326.

  4. Kim IT, Jung BY, Shim JY. Cholesterol crystals in aqueous humor of the eye with phacolytic glaucoma. J Korean Ophthalmol Soc. 2000 Sept. 41(9):2003-7.

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  15. Yoo WS, Kim BJ, Chung IY, Seo SW, Yoo JM, Kim SJ. A case of phacolytic glaucoma with anterior lens capsule disruption identified by scanning electron microscopy. BMC Ophthalmol. 2014. 14:133. [Medline].

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  19. Alm A, Grierson I, Shields MB. Side effects associated with prostaglandin analog therapy. Surv Ophthalmol. 2008 Nov. 53 Suppl1:S93-105. [Medline].

 
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Microscopy of the aspirate at the time of cataract extraction shows clumped, notched rectangular platelike crystals from the aqueous of a patient with phacolytic glaucoma (X160). Reproduced from J Korean Ophthalmol Soc 2000 Sep;41(9): Copyright © 2000, Korean Ophthalmological Society. All rights reserved.
Microscopy of the aspirate at the time of cataract extraction of a patient with phacolytic glaucoma shows round, regular cells with foamy cytoplasm consistent with macrophages (*). A leukocyte (white arrow) and an erythrocyte (black arrow) also are seen (X160). Reproduced from J Korean Ophthalmol Soc 2000 Sep;41(9): Copyright © 2000, Korean Ophthalmological Society. All rights reserved.
 
 
 
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