Management of Sport injuries Induced Post Traumatic Refractory Glaucoma And Traumatic Cataract by AGV and Cataract Surgery

1. Jitendra Kumar Singh Parihar¹
2. Jaya Kaushik²
3. D P Vats³
4. Hemant Singh Trehan⁴
5. Shantanu Mukherji⁵
6. S K Mishra⁶

Authors no 1,2,4,5 and 6 : 1,2,3,5, and 6 Army Hospital (Research & Referral), New Delhi, INDIA
Author no 3: Affiliation: 6 Armed Forces Medical College Pune, INDIA

Purpose: To analyze the efficacy and functional outcome of surgical intervention by AGV implantation and Phacoemulsification with IOL implantation in selected cases of post sport injury induced glaucoma and cataract.

Methods: This study is comprised of 14 male cases of 19 to 42 years of age group who sustained closed globe sport injuries belonging to squash ,Golf , Cricket ,football Boxing and Tenis ball injuries.The onset of glaucoma was within one week of injury. Other noted features were hyphema of variable grade, angle recession in 11, iridodialysis and traumatic iris sphincter tear in 3 and vitreous hemorrhage in 02 eyes. 04 eyes had Berlin's oedema .
Phacoemulsification and Ahmed glaucoma valve ( FP7)implantation was the preformed in all cases. Foldable IOL implant could be placed in 11 cases where as scleral fixated IOL was placed in remaining cases. Minimum follow-up was one year.

Results: Mean IOP reduction was 19mm Hg in first week .The onset of Hypertensive phase was observed at minimum 19 days to maximum 48 days after surgery. IOP was controlled without medication in 11 cases after one year, however remaining cases required two drugs. Best corrected visual acuity of 6/6 was obtained in all except in two eyes who had 6/12 and 6/18 due to posterior segment involvement. There were no significant change in visual field and optic nerve head status.

Conclusion : Concurrent AGV and Phacoemulsification surgery is a viable option for effective control of IOP and visual rehabilitation in coexisting traumatic Glaucoma and Cataract .