advertisement
Abstract #28049 Published in IGR 13-1
Long-term efficacy of phacoemulsification for primary closure angle glaucoma following filtering surgery
Hong Y; Zhang C; Li X-M; Wang X; Wang WChinese Ophthalmic Research 2010; 28: 1063-1068
Background: Phacoemulsification is proved to deepen anterior chambers and widen anterior chamber angles in primary angle closure glaucoma (PACG) eyes. In filtered PACG, it is uncertain whether phacoemulsification procedure may affect the extent of angle widening and anterior chamber depth. Objective: Present study was to investigate the long-term efficacy of clear corneal phacoemulsification on PACG eyes received filtering surgery. Methods: A prospective case series study was designed. Consecutive 19 eyes of 19 patients with PACG who received trabeculectomy from November 2005 to October 2006 were included in this trial. Clear corneal phacoemulsification was performed in one eye of all the patients. Intraocular pressure (IOP) and the numbers of antiglaucoma medicine were recorded before and 1 month, 3 months, 6 months, 12 months and 24 months after phacoemulsification in 15 patients. Ultrasound biomicroscopy (UBM) was examined before operation and 1 month and 24 months after operation, respectively. IOP and biological parameters of ocular anterior segment were compared between before and after phacoemulsification. Survival rate of filtration bleb was evaluated by Kaplan-Meier survival analysis. Written informed consent was obtained from the patients before the initial of this study process. Results: Fifteen patients finished the 22-month follow-up, and 4 cases lost because of death (2 cases) and bad compliance (2 cases). The IOP was (13.5 (plus or minus) 2.9) mmHg, (12.8 (plus or minus) 2.9) mmHg, (12.9 (plus or minus) 2.7) mmHg, (13.0 (plus or minus) 3.5) mmHg, (13.4 (plus or minus) 3.6) mmHg, (12.7 (plus or minus) 2.9) mmHg before and 1 month, 3, 6, 12, 24 months after phacoemulsification, showing insignificant difference among them (P = 0.443, P = 0.817). The accumulative successful rate was 100% and absolute successful rate was 87% at 24 months following the phacoemulsification. UBM measurement showed that the anterior chamber depth was significantly increased (Z = - 3. 411, P = 0.001), and the quadrents of improvement of the anterior chamber angle width was increased ((chi)(1) =8. 775, P = 0.006), and the height of the filtering bleb was obviously decreased (Z = -2.927, P = 0.003) after operation in comparison with before operation; while the eyes of reflectivity of blebs and visibility of the drainage route under scleral flap remained insignificant change before and after phacoemulsification (P > 0.05). Conclusion: Phacoemulsification in PACG eyes with functional filtering bleb do not elevate the IOP during the 24-month follow-up duration. LA: Chinese
Y. Hong. Peking University Third Hospital, Peking University Eye Center, Beijing 100191, China. puh3_ww@bjmu.edu.cn
Classification:
9.3.5 Primary angle closure (Part of: 9 Clinical forms of glaucomas > 9.3 Primary angle closure glaucomas)
12.12.3 Phacoemulsification (Part of: 12 Surgical treatment > 12.12 Cataract extraction)