Effects Of Phacoemulsification Combined With Goniosynechialysis On Primary Angle-closure Glaucoma With Cataract

Objective: To investigate the evaluation of the clinical efficacy of Phacoemulsification intraocular lens implantation combined with goniosynechialysis(PEI+GSL)in patients with acute angle-closure glaucoma(AACG)with cataract under direct vision without microendoscope.Methods: Analysis of patients who had been admitted to the between September 2021 and June 2022 and had the AACG and cataract.37 patients(39 eyes)were included in this study.The best corrected visual acuity(BACV),intraocular pressure(IOP),anterior chamber depth(ACD),and atrial angle closure range(PAS)visual field parameters were compared and analyzed preoperatively as well as 1d,1w,1mo,3mo,and 6mo after surgery.Examine the relationship between lens ratio(LT/AL)on postoperative IOP and anterior chamber.Results: In the preoperative period,all patients in this research had improved visual acuity,with 12 eyes(30.8%)having BCVA 0.1,18 eyes(46.1%)having BCVA 0.3,6 eyes(15.4%)having BCVA 0.5,and 3 eyes(7.7%)having BCVA >0.5.0.1 BCVA(10.3%),0.3 BCVA0.5(33.3%),and BCVA > 0.5(56.4%)in 4 eyes showed a substantial improvement in visual acuity 6 months after surgery in the subjects,IOP substantially decreased after surgery,with a mean preoperative IOP(mm Hg)of 50.62±11.49 and a mean postoperative IOP of16.33±3.80,14.13±2.93,14.08±3.33、13.28±2.52、13.95±2.23 at 1d,1 w,1 mo,3 mo,and 6 mo,respectively.The mean preoperative Log MAR BCVA was 0.94±0.58 and increased to 0.26±0.23 at 6 mo postoperatively.The extent of atrial angle closure was more evenly dispersed than before surgery,and no progressive row defects were observed in the postoperative visual field.Preoperative ACD(mm)and postoperative ACD(mm)were 1.58±0.24 and 3.55±0.23,respectively.While there was no statistical relationship between LT/ALr and ACD or IOP,there was a statistically insignificant relationship between 6 mo postoperative IOP and LT/ALr at the time of operation.There was a statistically weak correlation between 6mo postoperative IOP and LT/ALr at the time of surgery,while there was no statistical correlation between ?LT/AL r and ?ACD,?IOP.Conclusion: 1 In patients with APACG,PEI+GSL surgery is a safe and efficient method to increase visual acuity,lower IOP,and halt the progression of glaucomatous visual field damage.2 LT/ALr correlates with postoperative IOP,and using LT/AL r as a reference helps doctors create individualized treatment strategies.