DR.CHINMAY MAHATME

DR. GANESH V. RAMAN

Abstract

This is the case of a 54 year old female, who was a known case of Primary Angle Closure Glaucoma and Rheumatoid Arthritis, on treatment for both conditions. Visual acuity was 6/24 and 6/12 in the right and left eye respectively. Anterior segment examination was significant for scleral thinning, patent peripheral laser iridotomy, and immature cataract in both eyes. Posterior segment evaluation revealed a cup disc ratio of 0.5 in both eyes with no other significant findings. Intraocular pressure was 36 and 32 mm Hg in the right and left eye respectively. Gonioscopy showed an occludable angle.

The thinned-out sclera precluded a trabeculectomy, hence a PHACO with Gonioscopy Assisted Transluminal Trabeculotomy (GATT) was performed for both eyes with both eyes showing a good post-operative visual and intraocular pressure outcome. Vision improved to 6/6 with a reduction in intraocular pressure to 16mm Hg, in both eyes thus overcoming the limitation of trabeculectomy successfully.