DR. MANISHA RATHI

DR. DIXIT SONI, DR. JITENDER KUMAR, DR. SUMIT SACHDEVA

Abstract

A 78 year old lady presented with gross reduction in vision both eyes, limited to hand movements. She had cataract surgery with PCIOL 6 years ago in the L/E. O/E-Vision in both eyes was HM+, PL+, PR accurate. R/E had shallow AC, advanced nuclear cataract, sluggish pupil, with occluded angle. IOP R/E was 50mmHg. The angle was narrow with synechiae. The L/E had dislocated IOL and Glaucomatous optic atrophy, IOP was 30mmHg. The patient’s IOP had never been checked. After control of IOP and an informed consent, W-trabeculectomy with PCIOL was done in the R/E. Vision at 1 week follow-up R/E was 6/18, IOP was 10mmHg, glaucomatous disc with 0.6:1 C:D ratio was seen. We have found that W-Trabeculectomy is successful at very high IOP. All ophthalmologists must screen for glaucoma preoperatively, if it had been done in this case at the time of cataract surgery L/E, the vision of the patient could have been saved and irreversible glaucomatous damage avoided, with an improved quality of life.