Phacolytic glaucoma is preventable and curable disease with good visual outcome. Cataractous lens with intact capsule develops Phacolytic glaucoma. Phacolytic glaucoma is reported rarely in developed countries due to early intervention. Two forms of phacolytic glaucoma was described: [1] an acute presentation caused by rapid leakage of lens proteins occluding the trabecular meshwork and [2] gradual presentation with macrophages from immunologic response to lens proteins in the anterior chamber clogging trabecular meshwork. Patients with phacolytic glaucoma presents with unilateral acute onset pain, decreased vision of long duration, lacrimation and photophobia. On Examination the affected eye will have conjunctival injection, stromal and epithelial corneal edema, elevated intra ocular pressure, anterior chamber reaction, pseudohypopyon, particles on the lens capsule and anterior capsule wrinkling. Medical management was tried for forty eight hours before surgery. The objective of medical management was to control intra ocular pressure, inflammation and preparation to operate on a quiet eye. Surgical removal of lens by ICCE / ECCE with or without IOL is the definite treatment. Intraoperative complication rate was higher in phacolytic glaucoma. . Postoperative corneal edema persisted for more than a week. Good visual acuity achieved, in cases presented within < 5 days [56% > 6/12] was more than the cases presented between 6- 10 days [ 10 % > 6/12], whereas poor visual acuity of < 6/60 was more in cases presented beyond 10 days.

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R Dhivya

Glaucoma Consultant, Vasan Eye Hospital, Chrompet, Chennai 44