morphologic change and the clinical effects of phacoemulsification combined with goniosynechialysis in primary angle-closure glaucoma

METHODS:A prospective case series study. Seventy-nine cases(79 eyes)with cataract were enrolled. They went to our hospital for phacoemulsification and were diagnosed as PACG, in whom the closed anterior chamber angle was ≥180°(determined by gonioscopy dynamicly). They were observed for the changes of anterior chamber angle, intraocular pressure(IOP)and the best-corrected visual acuity(BCVA)pre- and post-operative from January to December in 2013.The angle opening distance 500(AOD500)and trabecular-iris angle 500(TIA500)before and after surgeries were analyzed using paired student t-test. The range of goniosynechia and BCVA before and after surgeries were analyzed using Kruskal-Wallis H test.

RESULTS:The IOPs of 58 eyes were normal(≤21mmHg)without any medications at 1mo after operation, and 56 eyes at 6mo after operation. The range of goniosynechia, AOD500, TIA500 and BCVA before operation had significant difference compared with those at 1 and 6mo after operation(P<0.05). The BCVA were improved except 8 eyes with optic atrophy.

CONCLUSION:Phacoemulsification combined with goniosynechialysisis is an effective method for angle closure glaucoma simply caused by pupillary block, coexisted with cataract. The angle closure glaucoma without pupillary block which has long course and the location of peripheral iris is anterior and the closure glaucoma coexisted with cataract caused by several different mechanisms should be treated with medicine management after phacoemulsification combined with goniosynechialysisis.