The Clinical Effect Of Trabeculectomy Combined With Phacoemulsification For Primary Angle-closure Glaucoma With Cataract

Objective To evaluate the effect and safety of trabeculectomy combined with phacoemulsification and intraocular lens implanation for primary angle-closured glaucoma with cataract.Method Retrospective study was performed in 49 cases(59 eyes)of primary angle--closure glaucoma patients with cataract treated with trabeculectomy combined with phacoemulsification and intraocular lens implanation from January 2007 to April 2008 in our hospital.35eyes with acute primary angle-closure glaucoma(APACG),24 eyes with chronic primary angle-closure glaucoma(CPACG).Visual acuity,intraocular pressure(IOP),thickness of lens,axial length of eyeball,peripheral anterior chamber depth,central anterior chamber depth,complications and medications were observed in all patients.Results1.IOP:Preoperative and 12 months postoperative IOP are 23.89±6.58mmHg,11.86±2.61mmHg respectively in APACG group(P＜0.01). Preoperative and 12 months postoperative IOP are 20.92±6.37mmHg, 13.63±2.27mmHg respectively in CPACG group(P＜0.01) in CPACG group.Postoperative IOP decreased in 10.93±6.87 mmHg in APACG group,while 7.11±5.34 mmHg in CPACG group(P＜0.05)2.Visual acuity:The naked visual acuity of 40 eyes in 59 eyes of PACG(67.8%) increased postoperatively compared with that preoperatively,however 17eyes(28.8%) did not increase or decrease, and 2eyes(3.4%) decrease.The naked visual acuity in APACG group, CPACG group are 0.39±0.33,0.35±0.30 respectively(P＞0.05)3.The peripheral depth of the anterior camber(PAC):Preoperative, postoperative PAC depth grade variation value are 2.00±0.80, 4.00±0.00 respectively in APACG group(P＜0.01),while 2.42±0.58, 4.00±0.00 respectively in CPACG group(P＜0.01).4.The central depth of the anterior chamber:Preoperative, postoperative central depth of the anterior chamber are 1.79±0.15mm,3.32±0.17mm respectively in APACG group(P＜0.01), while 1.84±0.19mm,3.37±0.20mm respectively in CPACG group (P＜0.01)5.The thickness of lens and the axial length of eyeballs:The preoperative thickness of lens(TL) In APACG and CPACG group are 5.23±0.24mm,4.97±0.32 respectively(P＜0.01).The preoperative axial length of lens(AL) In APACG and CPACG group are 22.14±0.94,22.41±0.89 respectively(P＞0.05).And TL/AL ratio in APACG and CPACG group are 2.37±0.14,2.22±0.16 respectively (P＜0.01)6.The surgical success rates:The total success rate,partial success rate are 94.3%,5.7%in APACG group,compared to 87.5%,8.3%in CPACG respectively.7.Complications:Mild and moderate corneal endothelial edema and fibrinous exudate were occurred in 15 eyes(25.4%) in all patients...