The Clinical Study Of Three Surgical Treatment Of Primary Angle-closure Glaucoma

Objectiveto study the clinical treatment and related factor of three surgical methods on Primary Angle-Closure GlaucomaMethodsThis was a retrospective case series study, one-hundred ninety-one eyes of164patients were diagnosed by primary angle-closure glaucoma between February2008and January2009, excluding hypertension, diabetes, et al that could cause other diseases of eyes, PACG was divided into acute and chronic type, According to surgery method, each type included trabeculectomy, phacoemulsification plus intraocular lens implantation and trabeculectomy, phacoemulsification plus intraocular lens implantation three surgical methods. Clinical datas included age, gender, course of disease, visiual acuity, intraocular pressure, cup disc ratio, mean defect, pattern Standard deviation, complications preoperative and that all followed up after surgery, spssl7.0software was used to analyze the preoperative and postoperative intraocular pressure, best corrected visual acuity,mean defect and pattern standard deactivation with Wilcoxon matched pairs signed-ranks test, postoperative intraocular pressure with independent sample rank test in between groups of each surgical approach, with one-way ANOVA in each group of three surgical approaches.Results(1) Postoperative Intraocular pressure with three surgical treatment was decreased significantly, the difference was statistically significant (Z=2.201, P=0.028); Combined Phacotrabeculectomy resulted lower mean postoperative IOP comparing with other two approaches(Trab:LSD-T test P=0.001; Phaco:LSD-T test:P=0.028);(2) Postoperative anterior chamber depth was deepen comparing with preoperative in cataract extraction((acute group PhacoTrab:Z=-4.198, P=0.000; Phaco:Z=-5.443,P=0.000; chronic group PhacoTrab:Z=-4.902, P=0.000; Phaco:Z=-5.012,P=0.000). Mean pattern standard deviation and mean defect was not significantly comparing with preoperative(Z=-1.604, P=0.109:Z=-0.943, P=0.435).(3) Complications was not statistically significant among three surgical approaches.33(26.19%) eyes that anterior chamber angle of cataract extraction was re-opening where pigmentation was0-Ⅱ grade, of4(7.14%) that IOP control was poor.ConclusionIOP control is better with trabeculectomy combined phacoemulsification in acute group and visual acuity improve significantly. There is not different on Complications comparing with trabeculectomy and phacoemulsification. IOP control was good in short time with Phacoemulsification managing acute and chronic glaucoma The re-opening angle may not maintain function, shallow anterior chamber occur may relate to shorter axial length and thicker crystal after trabeculectomy.