Capsule Wrinkling During Capsulorhexis in Patients with Primary Angle-Closure Glaucoma and Cataract

Abstract

Purpose: To evaluate the frequency of capsule wrinkling and associated factors during capsulorhexis in patients with primary angle-closure glaucoma (PACG) undergoing cataract surgery. Methods: This prospective study enrolled 91 eyes of 91 patients (26 eyes with PACG, 65 control eyes) who underwent cataract surgery. Capsule wrinkling during capsulorhexis was determined intraoperatively. The PACG group was evaluated for factors associated with capsule wrinkling such as intraocular pressure (IOP) on presentation, history of acute attacks, previous laser or trabeculectomy surgery, iris atrophy, peripheral anterior synechiae, and posterior synechiae. Results: The frequency of capsule wrinkling was higher in the PACG group (7/26, 26.9%) than in the control group (0/65, 0%) (P < 0.0001). Among the PACG patients, capsule wrinkling was associated with a higher IOP on presentation (54.71 +/- 16.15 mmHg) than in patients without capsule wrinkling (32.95 +/- 11.21 mmHg) (P = 0.001). Iris atrophy was significantly related to capsule wrinkling (P = 0.028), and the location of iris atrophy correlated with that of capsule wrinkling in 80% of cases (4/5). Conclusions: Capsule wrinkling during capsulorhexis was a significant finding in some patients with cataract and PACG, especially when the IOP on presentation was high and iris atrophy was present. Jpn J Ophthalmol 2010;54:401-406 (C) Japanese Ophthalmological Society 2010