Evaluate Surgical Procedure In The Treatment Of Coexisting Primary Angle-closure Glaucoma And Cataract

AIM To evaluate the preliminary clinical efficacy and safety of two types of microsurgery on management of coexisting primary angle-closure glaucoma and cataract.Methods The indications of three types of microsurgery were set up for a randomized comparison study on 87 cases(93 eyes) with primary acute or chronic angle-closure glaucoma and cataract which were performed trabeculectomy only(Trab group, group A), 32 cases 36 eyes, combined Phacoemulsification and Viscogoniosynechialysis plus intraocular lens implantation(PHACO+ IOL+ Viscogoniosynechialysis group, group B),24 cases 25 eyes,phacotrabeculectomy plus intraocular lens implantation(Phacotrabeculectomy+IOL group, group C), 31 cases 32 eyes. Analyzed and compared the difference of pre-operation and post-operation vision intraocular pressure(IOP),anterior chamber depth, visual acuity, postoperative complications and medications required. Followed up 6~12 months.Results The rate of visual acuity was developed in group A was 33.3%, and was 88% in group B,81.2% in group C, postoperative visual acuity in group B and group C were better than that in group A, the difference was statistically significant(?2=23.57,P<0.05). IOP in the three groups after the operation were all lower than those before the treatment respectively, the difference was statistically significant(P<0.05). UBM showed that the anterior chamber depth was deeper and anterior angle was widen or reopened in group B and group C postoperatively vs. preoperatively, while wasn't significantly change in group A. No seen intraoperative complications happened in three groups. The postoperative inflammatory response in group B was milder than group A and group C, but group A and group C was not statistically significant(P>0.05).Conclusion The indications of three types of microsurgery were benefits for management PACG. PHACO+IOL had good effect on the early stage of PACG. Combined Phacotrabeculectomy treatment had extensive indications and high successful rate and less complications, also can simultaneously increase visual acuity.