Glaucoma in aphakia and pseudophakia in the Chennai Glaucoma Study

Area of Science:

• Ophthalmology
• Public Health
• Epidemiology

Background:

• Glaucoma is a leading cause of irreversible blindness worldwide.
• Aphakia and pseudophakia, conditions after cataract surgery, may alter glaucoma risk.
• Understanding glaucoma prevalence in these specific populations is crucial for targeted interventions.

Purpose of the Study:

• To ascertain the prevalence of glaucoma in individuals with aphakia (absence of the lens) and pseudophakia (presence of an intraocular lens) in a rural South Indian population.
• To identify risk factors associated with glaucoma in this demographic.

Main Methods:

• A comprehensive ophthalmic examination was conducted on 3924 subjects aged 40 years and above.
• Glaucoma diagnosis in aphakic/pseudophakic individuals followed the International Society of Geographical and Epidemiological Ophthalmology criteria.
• Statistical analysis included univariate and multivariate assessments of risk factors.

Main Results:

• The prevalence of glaucoma among aphakes and pseudophakes was 11.2% (54 subjects out of 482).
• Univariate analysis identified aphakia, age, intraocular pressure (IOP), pseudoexfoliation, and extensive peripheral anterior synechiae as risk factors.
• Multivariate analysis confirmed IOP and aphakia as independent risk factors. Notably, 72.22% of affected individuals presented with normal IOP, and none were aware of their condition.
• Ocular morbidity, including unilateral or bilateral blindness, affected 22.22% of those with glaucoma.

Conclusions:

• Glaucoma represents a significant cause of ocular morbidity and blindness among aphakes and pseudophakes in this rural South Indian setting.
• The high rate of undetected glaucoma, particularly with normal intraocular pressure, highlights a critical gap in diagnosis and management.
• Public health strategies are needed to improve early detection and prevent vision loss in this vulnerable population.