Survival analysis of phacomorphic glaucoma at a tertiary hospital in North India

PURPOSE: To report the intraocular pressure (IOP) and visual outcomes in patients operated for phacomorphic glaucoma in a developing country METHODS: Patients undergone surgery for phacomorphic glaucoma between January 2015 and February 2018 with a minimum follow-up of 6 months were reviewed. Multinomial logistic regression was used to predict final visual acuity with different preoperative variables. A Kaplan-Meier analysis was done to calculate survival probabilities at different time points. RESULTS: Presenting IOP of study eye was 38.3±13.4 mmHg with 97.91% (n=94/96) patients on AGMs (mean: 2.7±1.08). Mean duration of complaints was 7.7±6.3 days. The most common postoperative complication was severe anterior chamber inflammation with or without fibrin membrane (in 29.16% eyes). The mean follow-up period was 14.5±9.2 months. At the last visit, the CDVA was 20/30 or better in 54/96 (56.25%) eyes, the mean IOP was 13.6±2.6 mmHg and 30 (31.25%) eyes required additional AGM with the mean number being 1.5±0.6. Two eyes required trabeculectomies for IOP control. The mean survival time of complete and qualified success was 28.5±1.9 and 41.2±0.05 months respectively. The probability of complete and qualified success at month 42 was 11% and 98%. Duration of complains and VCDR were found to be associated with final visual acuity. CONCLUSIONS: There was a positive correlation between shorter duration of symptoms with post-operative visual gain, but the glaucomatous damage showed a plateau effect at the IOP of around 35 mmHg. It is not the level of IOP, rather its duration which determines the degree of visual loss.