Preliminary outcomes of primary phacoemulsification plus intraocular lens implantation for primary angleclosure glaucoma

Purpose : To evaluate effects and safety of primary phacoemulsification plus intraocular lens implantation for controlled chronic angle-closure glaucoma (CACG) or primary angle-closure (PAC). Design : Prospective, non-randomized comparative trial. Methods : Two treatment groups were used. The IOL group included the use of phacoemulsification plus intraocular lens (IOL) implantation in 27 eyes. The LI group included treatment by laser iridotomy (LI) in 23 eyes. Intraocular pressure (IOP), numbers of antiglaucoma medications, complications, and corneal endothelial cell counts were examined in each group. Results : In the IOL group, IOP was significantly reduced from a preoperative mean of 14.8±4.2 mmHg to a 6-month-postoperative mean of 10.8±1.6 mmHg (P ＜.05). However, in the LI group, mean preoperative IOP was 15.5±4.1 mmHg, and the 6-month-postoperative IOP was 14.7±4.7 mmHg (P = .76). In the IOL group, no patient used anti-glaucoma medications 6-month postoperatively, whereas in the LI group, mean number of anti-glaucoma medications was 0.2±0.4 (P ＜.05). There were no significant differences in preoperative and postoperative corneal endothelial cell counts between IOL and LI groups (P = .39). Conclusions : Primary phacoemulsification plus intraocular lens implantation for controlled CACG or PAC seems to be a safe and effective method in reducing IOP. This procedure might become the first treatment of choice for controlled CACG or PAC with cataract

Three cases of Acanthamoeba keratitis diagnosed and treated in the early stage

Acanthamoeba keratitis (AK) is a severe infectious corneal ulcer that usually occurs in contact lens wearers. Although the number of AK cases in Japan has been increasing, many of these cases are diagnosed in the early stage and are treated adequately. This is probably because of the increased availability of various diagnostic techniques and the ever-increasing knowledge about AK among ophthalmologists. In this article, we described 3 cases of AK that were diagnosed and treated in the early stages of the disease, and we discuss why 1 of the cases had a less favorable prognosis than the other 2 cases, which had excellent prognoses, from an etiological point of view