The Systematic Review Of The Cataract Phacoemulsification For Primary Angle-closure Glaucoma Coexisting Cataract

Objective To make a systematic review of cataract phacoemulsification for primary angle-closure glaucoma (PACG) coexisting cataract by the rule of evidence-based medicine, and to assess the safety and effecty of this therapy for further clinic use. Design Systematic review. Methods A systematic review of all the relevant references was performed. The references were identified from pubmed, Chinese Bio-medicine Database. According to the inclusion and exclusion criterion, the evidence qualities were classified by the grades of the evidence quality for the therapy articles, and then we assessed the evidence by the final targets. Main Outcome Measures IOP, peripheral anterior chamber angle, depth of anterior chanber,anti-glaucoma medicines, complications. Results We assessed thirty-one articles, in which none was in gradeâ… ~â…¡,5 were in gradeâ…¢, and 26 were in gradeâ…£.The IOPs decrease by 1.9 ~35.9mmHg after the cataract phacoemulsification for the patients with PACG.The patients with the IOPs decrease value more than 20mmHg were all those with APACG(gradeâ…¢~â…£). In five papers the peripheral anterior chamber angle was described being wider than preoperation(gradeâ…£),and in four papers the PAS was lessened postoperately (gradeâ…¢~â…£).There were twelve papers in which anti-glaucoma medicines were described being reduced after that surgery(gradeâ…£).Six papers reported complication from IOP and 5.8% occurred the IOP peaks(gradeâ…¢~â…£).Conclusion The case reports showed that the pathologic anatomy of anterior chamber has been changed in patients with PACG after the cataract phacoemulsification . And IOPs dropped more in patients with APACG than with CPACG coexisting cataract after the cataract phacoemulsification .It's better to have phacoemulsification and intraocular Len implantation for patients with APACG coexisting cataract, which not only improve visual acuity but also control IOP .There were no serious IOP peaks in the early time after that surgery. There were no ample evidences to show that cataract phacoemulsification was more effective than trabeculotomy and combined trabeculotomy and cataract phacoemulsification for PACG.