Abstract
The management of acute angle closure combined with an extremely shallow anterior chamber and cataract remains complex. This study evaluated a technique of vitreous needle aspiration combined with phacoemulsification for the treatment of acute angle closure with continuous high intraocular pressure (IOP). We retrospectively reviewed the results of vitreous needle aspiration combined with phacoemulsification in 17 eyes (17 patients) with acute angle closure with continuous high IOP and coexisting visually significant cataracts between September 2018 and April 2020 at the glaucoma unit of the affiliated Changshu Hospital of Xuzhou Medical University. The main outcomes were the best corrected visual acuity (BCVA), IOP, anterior chamber depth (ACD), angle open distance 500 (AOD500), number of antiglaucoma medications, and surgery-associated complications. There were no complications during phacoemulsification and a foldable acrylic intraocular lens was implanted in the capsular bag in all 17 patients. For all patients, vitreous needle aspiration was successful at the first attempt. The BCVA improved from 2.02 ± 0.54 logMAR preoperatively to 0.73 ± 0.57 logMAR postoperatively at the final examination (p < 0.001). The mean IOP was 54.47 ± 5.33 mmHg preoperatively and 15.59 ± 2.35 mmHg at the final examination (p < 0.001) without any medication. The ACD was 1.70 ± 0.16 mm preoperatively and 3.35 ± 1.51 mm at the final examination (p < 0.001). The AOD500 was 0.07 ± 0.02 mm preoperatively and 0.51 ± 0.04 mm at the final examination (p < 0.001). Our vitreous needle aspiration technique can be performed safely in phacoemulsification for the management of acute angle closure with continuous high IOP.
Highlights
Angle closure disease involves closure of the ocular drainage angle, thereby blocking aqueous humor from being discharged through the trabecular meshwork [1]. It results in the elevation of the intraocular pressure (IOP), followed by the development of glaucomatous optic neuropathy [2]
Surgery is often challenging, the results are encouraging, with significant improvement in visual acuity; this improvement is less in patients with primary angle closure glaucoma than in patients with primary angle closure [7]
Consecutive patients with AAC treated between September 2018 and April 2020 at the glaucoma unit of the affiliated Changshu Hospital of Xuzhou Medical University (Changshu, China) underwent vitreous needle aspiration combined with phacoemulsification. e inclusion criteria were as follows: acute angle closure complicated with cataract, IOP uncontrolled by 2-3 days of drug treatment, and a very shallow anterior chamber
Summary
Angle closure disease involves closure of the ocular drainage angle, thereby blocking aqueous humor from being discharged through the trabecular meshwork [1]. Phacoemulsification with intraocular lens implantation results in a reduction in the IOP, as well as a significant reduction in the number of glaucoma medications. Erefore, we retrospectively reviewed the results of vitreous needle aspiration combined with phacoemulsification in cases. Consecutive patients with AAC treated between September 2018 and April 2020 at the glaucoma unit of the affiliated Changshu Hospital of Xuzhou Medical University (Changshu, China) underwent vitreous needle aspiration combined with phacoemulsification. E inclusion criteria were as follows: acute angle closure complicated with cataract, IOP uncontrolled by 2-3 days of drug treatment, and a very shallow anterior chamber. Vitreous needle aspiration was performed before phacoemulsification in all patients. Statistical analyses were performed using the SPSS 19.0 statistical software (SPSS Inc., Chicago, IL, USA), and p values
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