Outcome and surgical techniques of phacoemulsification combined with goniosynechialysis in eyes with acute primary angle closure glaucoma and cataract

• Main Authors: Nai-Yang Li, Qi Zhao
• Format: Article
• Language: English
• Published: Press of International Journal of Ophthalmology (IJO PRESS) 2016-02-01
• Series: Guoji Yanke Zazhi
• Subjects: glaucoma; cataract; phacoemulsification; outcome
• Online Access: http://ies.ijo.cn/cn_publish/2016/2/201602024.pdf

AIM:To investigate the outcome and surgical techniques of phacoemulsification combined with goniosynechialysis in eyes with acute primary angle closure glaucoma(APACG)and cataract.<p>METHODS: Sixty-seven patients(67 eyes)with APACG accompanied with cataract were treated with phacoemulsification from July 2012 to July 2014 in Zhongshan People's Hospital. Before operations, reducing intraocular press(IOP)sufficiently and relieving corneal edema were given to all patients. During the operations, goniosynechialysis were performed sufficiently. All patients were examined for visual acuity, IOP, number of anti-glaucoma drugs and range of opened anterior chamber preoperatively and at 3mo postoperatively. Data of anterior segment included central anterior chamber depth(CACD), anterior chamber volume(ACV), pupil diameter(PD)and others were detected by Pentacam and anterior segment ocular coherence tomography(AS-OCT). <p>RESULTS: The visual acuity improved from 0.87±0.09 preoperatively to 0.23±0.08 postoperatively and the difference was statistically significant(<i>t</i>=4.086, <i>P</i><0.01).Mean IOP decreased from 32.31±4.70mmHg preoperatively to 17.57±4.13mmHg postoperatively(<i>t</i>=20.266, <i>P</i><0.01). CACD measurements increased from 1.89±0.22mm preoperatively to 3.43±0.39mm postoperatively(<i>t</i>=24.266, <i>P</i><0.01). ACV increased from 78.24±8.96mm³ preoperatively to 148.65±17.85mm³ postoperatively(<i>t</i>=51.583, <i>P</i><0.01). The range of opened anterior chamber increased from 105.9°±10.81°preoperatively to 320.7°±35.77°postoperatively(<i>t</i>=46.677,<i>P</i><0.01). The number of anti-glaucoma drugs decreased from 3.05±0.40 preoperatively to 0.47±0.13 postoperatively(<i>t</i>=10.166, <i>P</i><0.01). PD before and after phacoemulsification were 3.14±1.28mm and 3.07±1.18mm respectively, which showed no statistical difference(<i>t</i>=1.157, <i>P</i>=0.247). Posterior capsule rupture occurred in 1 eye. Anterior fibrinous membrane of intraocular lens occurred in 2 eyes. <p>CONCLUSION: Phacoemulsification combined with goniosynechialysis can reduce IOP effectively and improve the stenosis of anterior segment, which is an useful treatment for patients with APACG and cataract.