The clinical effect of Ex-Press glaucoma drainage device implantation combined with phacoemulsification for primary acute angle-closure glaucoma with cataract and persistent ocular hypertension

Abstract

Objective To investigate the clinical effects and safety of Ex-Press glaucoma drainage device implantation combined with phacoemulsification (E-P P) for primary acute angle-closure glaucoma (PAACG) with cataract and persistent ocular hypertension. Methods The data of 30 eyes of 26 patients of PAACG with cataract and persistent ocular hypertension were retrospectively analyzed, who received E-P P surgery. The visual acuity, intraocular pressure(IOP) and complications were observed. Results All patients were followed up for 1 year. The complete success rate was 76.67% (23 eyes), the partial success rate was 23.33% (7 eyes), and the total success rate was 100.00%.The IOP before operation and 1 week, 1, 2, 3, 6 and 12 month after operation were (32.19±9.12), (10.30±5.07), (10.28±4.93), (10.87±4.22), (11.32±6.11), (12.12±6.07) and (13.05±5.26)mmHg(1 mmHg=0.133 kPa)respectively. Postoperative IOP was significantly decreased comparing with the preoperative one, and the difference was statistically significant (P<0.05). The visual acuity one week after operation was significantly improved comparing with preoperative one(Z=-4.19, P=0.000). Early postoperative complications included hyphema in 2 eyes, transient low IOP in 4 eyes, and choroidal detachment in 1 eye, and all of those complications healed within 4~14 days. Conclusion Ex-Press glaucoma drainage device implantation combined with phacoemulsification is safe and effective for the treatment of PAACG with cataract and persistent ocular hypertension. Key words: Cataract; Glaucoma, angle-closure, acute; Ocular hypertension, persistent; Phacoemulsification; Glaucoma drainage device, Ex-Press