The clinical effect of miniature glaucoma drainage device implantation combined with phacoemulsification for angle-closure glaucoma with cataract

Abstract

Objective To observe the treatment effect of Ex-PRESS miniature glaucoma drainage device implantation combined with phacoemulsification and intraocular lens implantation for the primary angle-closure glaucoma (PACG) with cataract. Methods Fifty-five eyes of 54 cases of PACG with cataract were selected, and they were randomly devided into clinical trail group(30 eyes of 30 cases) and control group (25 eyes of 24 cases). The clinical trail group was treated with Ex-PRESS miniature glaucoma drainage device implantation combined with phacoemulsification and intraocular lens implantation. The control group was treated with trabeculectomy combined with phacoemulsification and intraocular lens implantation. The visual acuity, intraocular pressure (IOP), corneal endothelium and central anterior chamber depth (ACD) were recorded and compared. Results At the last review of trail group after operation, the visual acuity (log MAR) was (0.47±0.31), which was better than the preoperative visual acuity (0.75±0.63)(P=0.002). The postoperative IOP in the clinical trail group decreased compared with the preoperative one (P<0.05). The ACD of the clinical trail group and the control group obviously increased after operation, and the difference in ACD between the two groups after operation was not statistically significant (P=0.451). The difference in corneal endothelial density between preoperation and postoperation in the clinical trail group was not statistically significant (P=0.162). The success rates of the clinical trail group and the control group were 96.67% and 92.00% respectively 6 months after surgery, and the difference was not statistically significant (P=0.585). The complication rate after operation of the clinical trail group (3.33%) was lower than that of the control group (24.00%)(P=0.022). Conclusion The operation of Ex-PRESS miniature glaucoma drainage device implantation combined with phacoemulsification and intraocular lens implantation, which can reduce IOP and improve visual acuity evidently with less complications, is a safe and effective combined operation for glaucoma with cataract. Key words: Glaucoma, angle-closure, primary; Cataract; Trabeculectomy; Phacoemulsification, aspiration; Drainage implant, glaucoma, miniature(Ex-PRESS)