Abstract:AIM: To analyze the efficacy of phacoemulsification(PHACO)with intraocular lens(IOL)implantation combined with goniosynechialysis(GSL)in the treatment of primary angle-closure glaucoma(PACG)with cataract and their effects on changes in retinal microstructural.
METHODS: Patients with PACG and cataract admitted to the hospital between January 2021 and June 2023 were retrospectively collected. According to the treatment modality, patients were divided into a group receiving PHACO+IOL+GSL(Group A)and a group receiving PHACO+IOL+trabeculectomy(Group B). Best-corrected visual acuity(BCVA), intraocular pressure(IOP), anterior chamber depth, foveal avascular zone(FAZ)perimeter, area, circularity index, and complications were compared between the two groups preoperatively and at different postoperative time points.
RESULTS: A total of 259 eyes of 259 patients with PACG and cataract were included and divided into two groups. Group A comprised 131 eyes of 131 patients(68 males, 63 females)with a mean age of 65.29±5.88 y; Group B comprised 128 eyes of 128 patients(70 males, 58 females)with a mean age of 65.39±6.42 y. At 1 wk and 3 mo postoperatively, IOP in Group B was significantly lower than that in Group A(both P<0.001). Anterior chamber depth at 3 mo postoperatively was significantly increased compared with preoperative values in both groups(both P<0.001), with no statistically significant difference between the groups(P>0.05). At 1 wk and 3 mo postoperatively, FAZ perimeter and FAZ circularity index in Group A were significantly greater than those in Group B(all P<0.01). The total incidence of complications in Group A was lower than that in Group B, and the difference was statistically significant(P<0.05).
CONCLUSION: Both PHACO+IOL+GSL and PHACO+IOL+trabeculectomy are effective in treating PACG with cataract. During the 3-month postoperative follow-up period, the former demonstrates a more pronounced effect in promoting retinal microstructural recovery and reducing the incidence of complications, whereas the latter is more effective in short-term IOP control.
