Observation On Efficacy Of Phacoemulsification For The Treatment Of Early Primary Angle-closure Glaucoma

ObjectiveTo observe the efficacy of phacoemulsification for the treatment of early primary angle-closure glaucoma(PACG).MethodsThe data of 54 eyes of 47 cases with primary angle-closure glaucoma in the Glaucoma Department in the First Affiliated Hospital of Zhengzhou University from Sep.2016 to Feb.2018 were collected and analyzed.All cases were randomly divided into two groups according to the random number table method.Group A,29 eyes of 23 cases,underwent phacoemulsification and intraocular lens implantation.Group B,25 eyes of 24 cases,underwent peripheral iridectomy.The patients were followed-up for 6 months,the intraocular pressure,visual acuity,central anterior chamber depth and peripheral anterior chamber depth,intraoperative and postoperative complications,and postoperative anti-glaucoma drugs usage were compared and analyzed between two groups.Results(1)The preoperative intraocular pressure in group A and B,were(20.10±4.20)mmHg and(21.20±3.10)mmHg(1mmHg=0.133kPa)respectively,there was no significant difference(t=-1.076,P=0.287).The postoperative intraocular pressure of the two groups at any observation points were significantly lower than that before operation(P < 0.05).(2)The visual acuity of group A was significantly improved at 3 days and 6 months after surgery,there were statistical significances before and after surgery(t=-7.710,P=0.000;t =-7.012,P=0.000).The visual acuity of group B was not changed at 3 days and 6 months after surgery,there were no significant differences between before and after surgery(t=0.184,P=0.855;t=0.744,P=0.460).(3)The depth of central anterior chamber in group A after surgery was significantly deeper than that before surgery(t=-24.021,P=0.000).The peripheral anterior chamber in group A was significantly deeper than that before surgery(H=28.310,P=0.000).Central anterior chamber depth and peripheral anterior chamber depth in group B after surgery were not changed,there were no significant differences(P>0.05).(4)During the followed-up period,the intraocular pressure of 2 eyes(6.9%)in group A were more than 21 mmHg,and were controlled after application of Brinzolamide eye drops.The intraocular hypertension occurred in 11 eyes(44.0%)in group B,and the IOP controlled after application of Treprostaglandin eye drops.The visual aberration occurred in 5 eyes(17.2%)in group A and the visual aberration occurred in 20 eyes(80.0%)in group B after surgery.There was no intraoperative and postoperative serious complication.ConclusionPhacoemulsification and intraocular lens implantation is safe and effective in the treatment of early primary angle-closure glaucoma.Compared with peripheral iridectomy,phacoemulsification and intraocular lens implantation not only can control intraocular pressure stably,avoid visual aberration that caused by defects in the iris and improve vision and visual quality,but also reduce complications and the possibility and risk of reoperation.