Phacolytic glaucoma; a clinicopathologic study of one hundred thirty-eight cases of glaucoma associated with hypermature cataract.

Abstract

More than half a century has elapsed since Gifford 1 first described glaucoma due to hypermature cataract and urged its prevention by cataract extraction. Verhoeff and LeMoine, 2 H. Knapp, 3 Kaufman, 4 Courtney, 5 Heath, 6 the Irvines,* Sugar, 10 Hubbersty and Gourlay, 11 and, recently, Ballen and Hughes 12 have reported on their experiences with this entity and have discussed its prevention and appropriate therapy. Theirs have all been reports based on small numbers of cases, and the condition is generally considered to be unusual. Glaucoma of this type, which usually has a violent onset, presents a remarkably bland, but strikingly characteristic, pathologic picture: liquefaction of the lens cortex, open iridocorneal angles, and the presence of large histiocytes which have engulfed liquefied lens material and are obstructing the trabecular apparatus. These features were first described by Zeeman, 13 who named the condition phacogenetic glaucoma. Irvine and Irvine * amplified