Management of Spherophakia- or Microspherophakia-associated Mild to Moderate Glaucoma with Lensectomy, Anterior Vitrectomy, and Iris-Claw Intraocular Lens Implantation.

Purpose: To report the outcomes of lensectomy, anterior vitrectomy, and iris-claw lens implantation in patients with spherophakia- or microspherophakia-related glaucoma. Methods: In this retrospective case series, we focused on patients with isolated microspherophakia or microspherophakia associated with various syndromes and mild to moderate angle-closure glaucoma who had undergone lensectomy, anterior vitrectomy, and iris-claw lens implantation. Results: We analyzed a total of 12 eyes of 6 patients with a mean age of 19 ± 6 years and a mean postoperative follow-up of 66 ± 12 months. All patients had lenticular myopia, and the mean refraction improved from - 7.26 ± 0.67 diopters (D) to - 1.18 ± 1.04 D after surgery. The mean corrected visual acuity improved from 0.92 ± 0.57 logMAR before surgery to 0.17 ± 0.15 logMAR at the last follow-up (P = 0.001). The mean intraocular pressure (IOP) decreased from 21.2 ± 3.9 mmHg on 1.9 ± 0.7 anti-glaucoma medications at baseline to 15.0 ± 1.5 mmHg (P = 0.006) on 0.8 ± 0.7 medications (P = 0.006) at the last follow-up. Conclusion: Lensectomy and iris-claw lens implantation in our cases not only decreased the IOP and reduced the number of glaucoma medications, but also improved the best-corrected visual acuity. Removal of the abnormally shaped lens likely contributed to these changes.