| Objective To observe phacoemulsification and goniosychialysis treatment effect in patients with acute angle-closure glaucoma, and to evaluate the safety and effectiveness of this surgical methods,explore the indications for this surgical methods,and provide a wider range of clinical reference for acute angle-closure glaucoma patients. Methods A prospective study Methods: June 2013- January 2014 received treatment in acute angle-closure glaucoma patients in our department of 43 cases(61 eyes); aged 45 to 84 years, an average of 61.72 ± 9.23 years old,to be anti-glaucoma medications to control intraocular pressure 40 mm Hg following before surgery,preoperative gonioscopy suggests the presence of more than 180 ° angle closure of the case and excluded others had undergone previous intraocular surgery affect the normal structure of the eye or corneal disease exist can not be checked or surgery randomly divided into phacoemulsification group(A) and trabecular(group B), were performed phacoemulsification and intraocular lens implantation and goniosychialysis and trabeculectomy,visual acuity before and after surgery, intraocular pressure, angle changes, and complications were 6 months to 1 year follow-up observation. The results in this study were analyzed using the statistical package spss11.0 processing of data, comparison of visual acuity and intraocular pressure before and after surgery using a paired t test, count data using goniosynechia range chi-square test. With P <0.05 was considered statistically significant. Results 1.Visual acuity:The mean preoperative visual acuity of group A and group B of patients did not show significant difference, group A and group B the postoperative average best corrected visual acuity was significantly improved compared with preoperative, and group A than in group B improved more obviously, the difference was statistically significant(P < 0.05).2.Intraocular pressure(IOP):Preoperative group A and group B patients no significant difference of IOP, after 6 months review, group B IOP drop is more obviously, and the IOP of group A and group B were significantly lower than preoperative(P < 0.001).3.Anterior chamber angle:The inspection of anterior chamber angle of A and B two groups have obvious differences, of postoperative 1 month revealed A group of 38 cases of eye corner has 36 cases all open, only 2 cases of eye there is below 180°angle close; Group B was no significant difference after surgery.4.Complication:A group of capsular rupture surgery does not appear, does not appear hyphema and iris disarticulation, postoperative have 19 eyes with varying degrees of corneal edema.There are 3 eyes in different degree of postoperative adhesion and fibrinoid exudation of anterior chamber, pupil shall be within 1 week after symptomatic treatment drugs are anterior chamber inflammation were significantly diminished. 2 eyes follow-up appeared, elevated intraocular pressure application 1 kind of effects in drug intraocular pressure can be controlled in the normal range. 9 eyes in group B a significant postoperative shallow anterior chamber, compression bandage, mydriatic wait after symptomatic treatment all can form anterior chamber, no special changes during the follow-up period. 2 eyes has different degree of synechia pupil eye and anterior chamber fibrinoid exudation, drugs can fade after symptomatic treatment. 1 eye in the follow-up of intraocular pressure out of control and viral any surgery in hospital. The crystalline turbidity and 4 eyes increase affect vision and phacoemulsification surgery. Conclusion Phacoemulsification and goniosynechialysis acute angle-closure glaucoma can significantly improve the patient’s visual acuity, intraocular pressure reduction, re-opening angle, even for the preoperative angle closure is bigger than 270°, is also able to get good treatment effect. And this surgical safety, significantly fewer complications than traditional glaucoma surgery, for the treatment of acute angle-closure glaucoma, is safe and effective. |
PDF Full Text Request