Phacolytic Glaucoma Treatment & Management

Updated: May 18, 2020
  • Author: Kayoung Yi, MD, PhD; Chief Editor: Inci Irak Dersu, MD, MPH  more...
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Treatment

Medical Care

Initial treatment of phacolytic glaucoma is focused upon acute lowering of IOP using a combination of topical and systemic IOP-lowering agents. Topical steroids also may facilitate IOP lowering and decrease pain.

Medical therapy is only a temporizing measure until cataract surgery can be scheduled.

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Surgical Care

The definitive treatment of phacolytic glaucoma (PG) is cataract extraction. Extracapsular cataract extraction (eg, phacoemulsification) with an intraocular lens implant has largely replaced intracapsular cataract extraction as the procedure of choice. [16, 17, 9, 18]

If PG is caused by a lens that has dislocated into the vitreous cavity, the procedure of choice is pars plana vitrectomy with removal of the lens from within the vitreous cavity.

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Diet

Instruct patients not to eat or drink if emergency cataract extraction is being considered.

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Prevention

Removal of mature or hypermature cataracts may be preventive.

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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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