Safety and efficacy of phacoemulsification and intraocular lens implantation in eyes with end‐stage chronic angle‐closure glaucoma

Abstract

AbstractPurpose To evaluate surgical outcomes of phacoemulsification and intraocular lens implantation in eyes with end‐stage chronic angle‐closure glaucoma (CACG).Methods Patients with medically controlled end‐stage CACG (mean deviation, < ‐19 dB) and clinically significant cataracts were enrolled in this prospective observational study. Standard phacoemulsification and intraocular lens implantation were performed. During at least 6 months of follow‐up, changes in visual acuity, intraocular pressure, visual field parameters, and number of antiglaucoma agents used were assessed. Intraoperative and postoperative complications were documented. Multiple regression analysis was performed to identify independent predictors of postoperative visual outcome.Results Twenty‐two eyes of 19 subjects were enrolled. The mean follow‐up period was 13.7 months (6–27 months). Corrected visual acuity improved from 0.63 ± 0.50 logarithm of the minimum angle of resolution (logMAR) preoperatively to 0.20 ± 0.31 logMAR postoperatively (p < 0.001). Intraocular pressure decreased from 14.05 ± 3.11 mmHg to 10.55 ± 1.79 mmHg (p < 0.001). No change was found in visual field parameters or number of antiglaucoma agents used. During surgery, 2 eyes had zonular dialysis and 1 eye had posterior capsule rupture. After surgery, 1 eye required additional trabeculectomy due to uncontrolled intraocular pressure after phacoemulsification. Preoperative visual acuity and mean sensitivities of 4 central points of the visual field were independent predictors of postoperative visual outcome.Conclusion Phacoemulsification and intraocular lens implantation was performed safely and effectively in end‐stage CACG eyes with cataracts.