advertisement
AIM: To investigate the clinical effects and indications of phacoemulsification plus intraocular lens (IOL) implantation per se and combined with goniosynechialysis (GSL) in the management of primary angle-closure glaucoma (PACG). METHODS: Twenty-nine cases (43 eyes) with PACG and cataract were divided into three groups according to preoperative degrees of synechial angle closure (SAC):16 eyes of group A with equal to or less than 180 degrees SAC, 15 eyes of group B with more than 180 degrees but equal to or less than 270 degrees SAC, 12 eyes of group C with more than 270 degrees SAC. Group A was treated with phacoemulsification plus IOL implantation. Both group B and C was treated with phacoemulsification and IOL implantation combined with GSL. Intraocular pressure (IOP), anterior chamber angle and visual acuity were monitored during follow-up for 9-24 months in these eyes. RESULTS: The IOPs of 16 eyes (100%) in group A, 14 eyes (93%%) in group B and 2 eyes (17%) in group C were normal without any medications. The IOP of 1 eyes (7%) in group B was normal with a single antiglaucomatous eye drops. The IOPs of 10 eyes in group C were higher than 21mmHg after medications, 8 eyes required trabeculectomy. The chamber angles became wider and SAC were mostly reopened after surgery in all eyes. The postoperative outcome of best corrected visual acuity were ever improved in 38 of 43 eyes (88%). CONCLUSION: Phacoemulsification plus IOL implantation is able to effectively control IOP and also improve the visual acuity of PACG with equal to or less than 180 degrees SAC and with cataract. For SAC ranging from 180 to 270 degrees, the similar effects can also be obtained via phacoemulsification plus GSL. However, trabeculectomy may be necessary for cases of SAC more than 270 degrees. LA: Chinese
Dr. Z.-H. Feng, Department of Opthalmology, Hospital of Medical College, Xi'an Jiaotong University, Xi'an 710004 Shaanxi Province, China. fzhwy@126.com
12.14.3 Phacoemulsification (Part of: 12 Surgical treatment > 12.14 Combined cataract extraction and glaucoma surgery)