Aims To evaluate the efficacy of lens removal plus intraocular lens (IOL) implantation for spherophakia with secondary glaucoma.

Methods A series of 19 patients (n=24 eyes) were split into two groups according to the degree of zonular abnormality as follows: group 1 (within the range of one quadrant, n=7 eyes) and group 2 (beyond the range of one quadrant, n=17 eyes). The patients in group 1 underwent phacoemulsification+capsular tension ring (CTR)+IOL, whereas patients in group 2 underwent pars plana lensectomy with scleral-fixated posterior chamber (PC) IOL implantation. The best corrected visual acuity (BCVA) (logMAR unit) and intraocular pressure (IOP) were documented at presentation and at 1 day, 7 days, 3 months, 1 year and 3 years postoperatively.

Results The IOP in both groups significantly decreased after surgery (group 1:28.84±5.36 mm Hg at presentation, 15.86±0.79 mm Hg at the 3-year visit, t=6.34, p=0.000; group 2:26.18±12.16 mm Hg at presentation, 14.54±3.40 mm Hg at the 3-year visit, t=3.80, p=0.01). The BCVA increased from 0.79±0.36 at baseline to 0.44±0.38 at the 3-year follow-up but did not reach a significantly different level in group 1 (t=1.72, p=0.11), whereas the BCVA significantly increased from 1.15±0.75 at baseline to 0.43±0.38 at the 3-year visit in group 2 (t=3.45, p=0.02).

Conclusions Both phacoemulsification+CTR+IOL and lensectomy with scleral-fixated PC IOL implantation are effective in lowering the IOP and enhancing the visual acuity in patients with spherophakia and secondary glaucoma.