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Abstract #13545 Published in IGR 8-1
The clinical outcomes of cataract extraction by phacoemulsification in eyes with primary angle-closure glaucoma (PACG) and co-existing cataract: a prospective case series
Lai JS; Tham CC; Chan JCJournal of Glaucoma 2006; 15: 47-52
PURPOSE: To evaluate the clinical outcomes of minimally invasive cataract extraction by phacoemulsification, with primary intraocular lens implantation, in eyes with primary angle-closure glaucoma (PACG) and co-existing cataract. MATERIALS AND METHODS: Consecutive primary angle-closure glaucoma patients with co-existing visually significant cataract were invited to participate in this prospective study. After obtaining informed consent, cataract extraction by phacoemulsification through a clear corneal incision was performed under topical anesthesia. Foldable intraocular lenses were implanted in the same setting. These patients were then followed up for a minimum of 1 year. Outcome measures included intraocular pressure (IOP), requirement for glaucoma drugs, and visual acuity. RESULTS: Twenty-one primary angle-closure glaucoma eyes of 21 patients were recruited. Mean age (± SD) was 73.7 ± 8.1 years (range, 60-87 years). There were 12 female patients and 9 male patients, with 13 right eyes and 8 left eyes. Nine eyes (42.9%) had history of acute primary angle closure. Mean follow-up duration was 20.7 ± 3.6 months (range, 13-26 months). Intraocular pressure was decreased from a mean preoperative level of 19.7 ± 6.1 mmHg (range, 11 mmHg-40 mmHg) to 15.5 ± 3.9 mmHg (range, 9 mmHg-26 mmHg) at final follow-up (P = 0.022) (paired t test). The number of glaucoma eye drops required was decreased from a mean preoperative level of 1.91 ± 0.77 (range, 1-3) to 0.52 ± 0.87 (range, 0-3) at final follow-up (P < 0.001) (paired t test). In 10 eyes (47.6%), visual acuity improved significantly after surgery. In 9 eyes (42.9%), visual acuity remained the same. In 2 eyes (9.5%), visual acuity deteriorated significantly after surgery. Mean cup-to-disc ratio was 0.6 ± 0.2 (range, 0.3-0.9) preoperatively, and 0.7 ± 0.2 (range, 0.3-0.9) postoperatively (P = 0.047) (paired t test). CONCLUSIONS: In primary angle-closure glaucoma patients with co-existing cataract, cataract extraction alone (by phacoemulsification) can significantly reduce both intraocular pressure and the requirement for glaucoma drugs.
Dr. J.S. Lai, Department of Ophthalmology, United Christian Hospital, Kowloon, Hong Kong SAR, Peoples' Republic of China. laism@ha.org.hk
Classification:
9.3 Primary angle closure glaucomas (Part of: 9 Clinical forms of glaucomas)
12.12.3 Phacoemulsification (Part of: 12 Surgical treatment > 12.12 Cataract extraction)
