Vitreous Aspiration and Phacoemulsification in the Management of Uncontrolled Acute Primary Angle-Closure Glaucoma after YAG Laser Iridotomy

Abstract

Purpose: To report the management of co-existence of uncontrolled acute primary angle-closure glaucoma (PACG) and cataract by pars plana vitreous aspiration, phacoemulsification and foldable intraocular lens (IOL) implantation. Methods: Interventional case report Results: A 64-year-old woman had an acute PACG and cataract in the right eye. After the treatment of YAG laser iridotomy (LI), high intraocular pressure (IOP) still persisted with anti-glaucomatous agents. Vitreous aspiration, clear corneal phacoemulsification and foldable IOL implantation were performed. Postoperatively, IOP decreased to 12 mmHg without medication and anterior chamber became deeper. The visual acuity improved from 20/60 preoperatively to 20/25 postoperatively. Conclusion: If uncontrolled acute PACG with cataract could not be relieved by the treatment of YAG LI and maximal medical medications, combined vitreous aspiration, phacoemulsification, and foldable IOL implantation may be a safe and effective procedure in reducing IOP and improving visual acuity with the option of future trabeculectomy.