Visual Outcome of Lens-induced Glaucoma versus Control after Cataract Surgery with Intraocular Lens Implantation: A-5-year Registry Study in East Coast of Peninsula Malaysia

Abstract

Introduction: To compare cataract surgery outcome between lens-induced glaucoma (LIG) and control group. Material and Methods: Data extracted from National Eye Database of cataract surgery performed between 2018 and 2022 in Kelantan and Terengganu. LIG group were among phacomorphic & phacolytic glaucoma whereas control group were among senile cataract. Patients with other ocular comorbidity and missing postoperative data were excluded.  Good visual acuity outcome was defined as best corrected visual acuity (BCVA) 6/12 or better at 6 weeks onwards postoperatively. Results: Sixty-six eyes of LIG cases were included, where 42 eyes were phacomorphic and 24 eyes were phacolytic. The control group comprised 69 eyes. Mean ages for the LIG and control groups were 65.24±12.23 years and 65.97±9.12 years, respectively (p = 0.695). Preoperative VA showed that 95.5% of LIG cases had vision worse than 3/60, compared to only 42.0% in the control group. Surgical durations were significantly longer in the LIG group (46.10±20.53 minutes) compared to the control group (31.12±13.67 minutes) (p < 0.001). The mean postoperative logMAR BCVA was higher in the LIG group (0.69±0.84) than in the control group (0.10±0.14) (p < 0.001). Good VA was achieved in 95.7% of the control group versus 53.0% of the LIG group (p < 0.001). LIG patients exhibited a 19.49 times higher risk of poor postoperative visual outcome compared to controls. Operative complications recorded only in LIG group, comprising posterior capsule rupture (19.7%) zonulysis (7.6%), and corneal edema (1.5%). Conclusion: LIG patient experienced longer surgical durations, more complications and poorer visual outcomes.