Clinical Study Of PPI-GSL In The Treatment Of Advanced Stage Chronic Angle-closure Glaucoma With Cataract

Objective：To evaluate the clinical effects of phacoemulsification and posterior chamberintraocular lens implantation combined with goniosynechialysis (PPI+GSL) in themanagement of advanced stage chronic angle-closure glaucoma (CACG) with cataract.Methods：19patients20eyes of advanced stage CACG with cataract were treated withPPI+GSL. And then, making pupil shrinked. Pilocarpine and methazolamide tablets wereused at primal time after operation. The mean follow-up duration was6-36months. Thevisual acuity, intraocular pressure (IOP), anterior chamber depth, configuration of chamberanger, the number of anti-glaucoma medications, visual field and so on were examined.Results：The average visual acuity was significantly increased from a preoperative meanof (0.20±0.14) to （0.47±0.16）at time of final follow up (P<0.01). The average IOP wasreduced in20eyes from a preoperative mean of (25.80±5.08)mmHg to (15.75±3.08)mmHgat time of final follow up(P<0.01) respectively．The IOP remained controlled(≤21mmHg)without anti-glaucomatous medication in16eyes (80%). All of the eyes (100%) remainedthe IOP controlled with or without antiglaucomatous medication. The depth of anteriorchamber was deepened from a preoperative mean of (2.12±0.11）mm to a postoperative of（3.45±0.18）mm (P＜0.01). Enrolled patients whose limbal chamber depth were less than1/2corneal thickness (CT) were18eyes and less than1/3CT were9eyes before the operation, and all of them whose limbal chamber depth were more than1CT,postoperatively. The postoperative gonioscopy showed that the chamber angle was open in adifferent leve1from （281.00±49.19）°to（52.25±36.69）°,(P＜0.01)； The visual field of20eyes was not worsing after6months of surgery． The number of anti-glaucomamedications from （2.9±0.8）to（0.25±0.55）(P＜0.01)．No severe complications developedduring the operation, only4eyes developed significant stromal edema of the cornea, whichsubsided with conservative therapy within1week postoperatively.Conclusion：PPI+GSL may be an effective and safety treatment option for advanced stageCACG with cataract, but long-term efficacy of PPI+GSL was indefinite.