Impact of Combined Lentectomy, Vitrectomy, and Trabeculectomy on Secondary Glaucoma due to Lens Dislocation

This study aims to evaluate the clinical effectiveness of combining lentectomy, vitrectomy, and trabeculectomy in treating secondary glaucoma caused by lens dislocation.

We retrospectively analyzed data from 20 cases (20 eyes) of traumatic lens dislocation accompanied by secondary glaucoma. The patients underwent standard 3-port pars plana vitrectomy and the upper trabeculectomy. Mitomycin C (MMC) was applied below scleral flap during surgery. We evaluated preoperative and postoperative visual acuity, intraocular pressure (IOP), and any complications.

Postsurgery, visual acuity improved in 18 of the 20 eyes (90%). The operation was considered successful if postsurgery, the use of topical antiglaucoma drugs was no longer necessary or reduced, and the IOP was controlled within the range of 6-21 mmHg. Of the cases studied, 18 eyes (90%) had a successful outcome, while 2 eyes (10%) were unsuccessful, with an IOP of less than 6 mmHg. All 20 eyes (100%) developed follicles postoperatively. Complications included intraocular hemorrhage in 3 eyes, low intraocular pressure in 6 eyes, choroidal detachment in 4 eyes, and hyperfiltration in 2 eyes.

The combination of lentectomy, vitrectomy, and trabeculectomy presents a safe and effective method for reducing intraocular pressure and improving visual acuity in patients with secondary glaucoma resulting from lens dislocation.