Lens replacement to address space narrowing Many middle-aged and elderly glaucoma patients have a question: Why do they have sudden onset of glaucoma when they are older when their vision was good when they were young? “There are many causes of glaucoma, but a part of closed-angle glaucoma is the fault of having too good vision when you were young.” It turns out that many people have good vision when they are young and can see very far away, but in fact, this “too good” vision is known as the hidden hyperopia state. In the hyperopic state, the anterior chamber is shallow, the iris is bulging forward, the anterior chamber angle is narrow, and the atrial stream is not flowing well, which sets the stage for sudden onset of glaucoma.
When a person grows old, the inevitable “old eyes” – presbyopia, seeing near objects becomes difficult, at this time, in order to focus on the retina, the brain directs the crystal to focus, the crystal expands, squeezing the iris forward, when the iris blocks the atrial water outlet, the eye pressure can rise, and there is a sudden glaucoma. When the iris blocks the pathway for atrial fluid, the intraocular pressure can rise, potentially leading to the development of glaucoma.
In 2001, an ophthalmologist in Singapore proposed the prevention of this type of glaucoma by replacing the lens. This procedure is performed in patients with closed-angle glaucoma who do not have a cloudy lens, and is performed after an ultrasound biomicroscopy that reveals crowding at the anterior chamber angle. The purpose of the surgery is to replace the original lens thickness of about 4-5 mm with an IOL of only 1 mm, allowing for a relatively larger space in the eye, changing the narrowing of the anterior chamber angle and allowing for a smooth flow of water out of the atrium. With the surgery, patients with pathological factors of closed-angle glaucoma can be kept away from glaucoma for life.
IOL replacement can control IOP well and restore vision quickly with few complications, but the procedure must be performed by a skilled and precise physician with a 100% success rate to do this surgery; otherwise, it will not only fail to achieve the desired surgical purpose, but also cause more serious surgical complications.