K 189Secondary neovascular angle closure glaucoma in diabetes mellitus risk factor cataract surgery
U. Schönherr, A. Händel
Background: Neovascularization of the iris in diabetes patients can lead to angle closure and is a potential risk factor for the existence of the whole eye. A sufficient retinal laser therapy may in many cases control this neovascularization. This study analyzes the influence of cataract surgery on the incidence of a irreversible angle closure glaucoma caused by rubeosis iridis.
Methods: 104 patients' data were analyzed in this study. All patients underwent cyclokryotherapy for uncontrolled angle closure glaucoma due to diabetic neovascularization.
Results: 60% of the patients were female, the presence of diabetes mellitus was known between one and 59 years (mean 19.3 years), 70% of the patients underwent retinal laser therapy previously. The patients' age ranged between 26 und 89 years, 47% of the eyes had previous cataract extraction with posterior chamber lens implantation. 45% of the cataract extraction was done within one year before the occurence of the angle closure glaucoma. The incidence of rubeosis was significantly increased in eyes with previous cataract extraction as in the fellow eyes without cataract extraction.
Conclusion: Cataract extraction seems to be a risk factor for neovascularization of the anterior segment in diabetes patients with incomplete retinal laser coagulation. The cataract extraction diminish the barrier function between anterior and posterior segment and seems to result in a higher concentration of angiogenetic factors in the anterior segment. It seems to be necessary to follow patients with diabetes after cataract extraction very closely and to complete retinal laser coagulation if necessary.
Department of Ophthalmology, University of Erlangen-Nürnberg, Schwabachanlage 6, 91054 Erlangen