Clinical study on the effect of phacoemulisification in the management of angle-closure glaucoma

Abstract

Objective To evaluate the effectiveness of anterior chamber angle and IOP after phacomulsification with foldable posterior chamber intraocular lens implantation(PEA+IOL)in management of primary angle closure glaucoma(PACG)in different extent closure angle with cataract.Methods Phacomulsification with foldable PC-IOL implantation was performed in 26 patients(32eyes)with ACG in our hospital.According to angle closure degrees and peripheral anterior chamber before operation,the patients were divided into two groups.Group A:20 eyes with less than 1/2 perimeter closure angle and peripheral anterior chamber;Group B:12 eyes with more than 1/2 perimeter closure angle and peripheral anterior chamber.The best corrected visual acuity(BCVA),intraocular pressure(IOP),anterior chamber angle width and anterior chamber depth (ACD)were measured and recorded.Results Vision of all 32 eyes improved differently and deepening of anterior chamber depth were found.Intraoculur pressure(IOP)was fall obviously in two groups without medication.There was significant difference between preoperation and postoperation.But there were no significant difference between the two groups postoprration.The angles examined by gonioscopy and UBM were wider than that of preoperation.the extent of any touch or adhesion between iris and trabeculae reduced.All angle circumference opened again in 12 eyes(group A),there were less than 1/4 perimeter angle closure or syncchia in 8 eyes(4 eyes in group A,4 eyes in group B),1/4-1/2 perimeter angle closure in 8 eyes(4 eyes in group A,4 eyes in group B),1/2-3/4 perimeter angle closur in 3 eyes(group B),more than 3/4 perimeter angle closure in 1 eyes(group B).Conclusions Phacomulsification with foldable PC-IOL implantation can manage the ACG with all anterior chamber closure or synechia abroad effectively,but the ACG possibly recurred in that more than 1/2 perimeter even whole angle closure with uncontrolled IOP preoperation. Key words: Phacomulsiflcation; Introcular; lens; Angle-closure; glaucoma; Treatment