The Efficacy Of Phacoemulsification In Eyes With Primary Angle Closure Or Primary Angle-closure Glaucoma Which Is Combined With Cataract

Glaucoma and cataract are common in senior citizens.There are three strategies, totackle with the glaucoma patients combined with cataract:1.extracapsular cataractextraction or phacoemulsification;2.cataract extraction combined withtrabeculectomy;3.firstly trabeculectomy,secondly cataract extraction. Choosing thesimple cataract surgery have several adventages such as high success rate, lesscomplications and solving the problem simultaneously.In recent years,many researchershave found the efficacy of cataract surgery in curing various types of glaucoma with orwithout cataract.The definition of primary angle closure(PAC) and primaryangle-closure glaucoma(PACG) were brought up and explained by Foster(2002),whodescribed a new criterion for diagnosis of glaucoma in population based prevalencesurveys that is also called ISGEO criterion.This criterion is widely acceptedabroad,which is still controversial in China.Objective: To evaluate the efficacy of phacoemulsification with Intraocular lensimplantation for primary angle closure(PAC) and primary angle-closure glaucoma(PACG) with cataract.Method: The research adopt the new diagnostic criterion of ISGEO.24PAC patients and27PACG patients were included in this study and cataract extraction byphacoemulsification were performed after the intraocular pressure(IOP) were controlledunder21mmHg (1mmHg＝0.133kPa)，the patients were followed up for6months, outcome measures included the best corrected visual acuity,the intraocularpressure(IOP), the extent of peripheral anterior synechiae (PAS),requirement forglaucoma drugs and complications.Results: The best corrected visual acuity was significant improved (Z=5.025，P＜0.001),postoperative reduction of IOP was significant in PAC group from14.04±1.01mmHg to11.98±1.33mmHg at last follow-up （t=8.907，P=0.000）, and in PACGgroup from17.11±1.23mmHg to5.08±2.96mmHg（t=3.698，P=0.001）at lastfollow-up,with no significant difference between the groups.（t=0.018, P=0.986）.The postoperative extent of PAS was relieved in two groups(PAC: Z=6.120,P＜0.001，PACG: Z=2.345, P=0.019).Conclusions: In PAC and PACG patient with co-existing cataract, phacoemulsificationcan significantly improve visual acuity, reduce IOP and reopen part of PAS, preventingIOP rise in a short term(6months).The reduction of IOP6months afterphacoemulsification is no significant difference between two groups.