Abstract:AIM:To evaluate the effect and safety of phacoemulsification and intraocular lens implantation combined with trabeculectomy for primary angle-closured glaucoma with cataract.
METHODS: Retrospective study was performed in 49 cases(59 eyes)of primary angle-closure glaucoma with cataract patients treated with phacoemulsification and intraocular lens implantation combined with trabeculectomy. Among them, 35 eyes were acute primary angle-closure glaucoma(APACG), 24 eyes were chronic primary angle-closure glaucoma(CPACG).Visual acuity, intraocular pressure(IOP), thickness of lens, axial length of eyeball, central anterior chamber depth, complications and medications were detected in all patients followed up until 6-12 months.
RESULTS: 1)Preoperative and postoperative IOP were 23.9±6.6mmHg, 11.7±2.6mmHg respectively in APACG group(n=35, P<0.01), and 20.9±6.5mmHg, 14.5±1.4mmHg respectively in CPACG group(n=24, P<0.01). Postoperative IOP of APACG decreased in 11.3±5.9mmHg, while 7.4±7.1mmHg in CPACG group(P<0.05). 2)The visual acuity of 44 eyes in 59 eyes of PACG(74.6%)increased postoperatively compared with that preoperatively(P<0.05). 3)Preoperative, postoperative central depth of the anterior chamber were 1.79±0.15, 3.32±0.17mm respectively in APACG group(P<0.01), while 1.84±0.19, 3.37±0.20mm respectively in CPACG group(P<0.01). 4)The thickness of lens and the axial length of eyeballs ratio in APACG and CPACG group were 2.26±0.16, 2.14±0.13 respectively(P<0.01). 5)The total success rate, partial success rate were 94.3%, 5.7% in APACG group, compared to 87.5%, 8.3% in CPACG respectively. 6)Mild and moderate corneal endothelial edema and fibrinous exudate were occurred in 15 eyes(25.4%)in all patients respectively.
CONCLUSION:Phacoemulsification and intraocular lens implantation combined with trabeculectomy is effective and safe treatment for primary angle-closure glaucoma with cataract patients, especially for acute primary angle-closure glaucoma compared with chronic primary angle-closure glaucoma.
