Clinical Study On The Management Of Chronic Angle-closure Glaucoma With Cataract By Phacoemulsification Combined With Goniosynechialysis

Objective The aim of this study is to evaluate the clinical efficacy of phacoemulsification combined with goniosynechialysis(Phaco-GSL) for the management of chronic primary angle-closue glaucoma(CACG) with cataract. Methods 24 cases(27 eyes) with chronic angle-closure glaucoma were divided into group A(peripheral anterior synechia 180°~270°,16 eyes) and group B(peripheral anterior synechia 270°~360°,11 eyes). The observed signs included visual acuity, intraocular pressure(IOP), anterior chamber depth(ACD) and corner changes after surgery. All patients were followed-up for three months. Results Visual acuity in both groups was significantly improved after surgeries with statistically greater improvement observed in group A(P<0.05, group A: 0.3±0.16 before surgery vs. 0.53±0.2 after surgery; Group B: 0.32±0.16 before surgery vs. 0.44±0.26 after surgery). IOP: the IOP was(4.214±1.55) Kpa in group A and(4.631±1.153) Kpa in group B, whereas IOP in the group A at three days, two weeks, one month, three months after operation was decrease to 93.8%, 87.5%, 87.5%, 81.3%.There are two eyes in group B with normal IOP, and the IOP in other eyes was gradually increased with two weeks. ACD: Both groups showed significant increases in ACD after surgeries(group A: 1.98±0.31 mm before surgery vs. 3.55±0.31 mm after surgery; group B: 1.86±0.09 mm before surgery vs. 3.51±0.22 mm after surgery). Anterior chamber angle:all the anterior chamber angles broaded after surgery. Conclusion These findings suggest that the Phaco-GSL can be performed on patients with chronic angle-closure glaucoma when peripheral anterior synechia within 180°~270°; whereas trabeculectomy should be performed when peripheral anterior synechia within 270°~360°...