Comparison Of Efficacy Between Surgery And Laser Therapy For Glaucoma With Cataract

ObjectiveTo observe the changes of intraocular pressure,best corrected visual acuity,anterior chamber parameters,chamber angle closure range before and after cataract phacoemulsification and laser peripheral iridotomy(LPI)in the treatment of primary angle closure(PAC),and to compare the effects of the two treatments.Methods59 eyes of 51 cases of PAC with cataract admitted to the ophthalmic ward of our hospital from May 2018 to June 2019 were collected.The patients were divided into two groups according to their treatment patterns.Phacoemulsification was performed in the phacoemulsification group(28 eyes)and LPI was performed in laser group(31eyes).Preoperative and postoperative intraocular pressure,best corrected visual acuity,anterior chamber parameters(central anterior chamber depth(CACD),peripheral anterior chamber depth(PACD)(superior,inferior,nasal,and temporal),anterior chamber angle(ACA),anterior chamber volume(ACV)),chamber angle closure range,complications were observed in the two groups.ResultsThe preoperative intraocular pressure in phacoemulsification group and laser group were(23.32±3.31)mm Hg and(22.79±2.89)mm Hg(1mm Hg=0.133k Pa)respectively,and the difference was not statistically significant(t=0.658,P=0.513).The intraocular pressure of the two groups were decreased at each time point after surgery.Intraocular pressure in the phacoemulsification group was lower than that in the laser group at 1 and 3 months after surgery,and the difference was statistically significant(t=3.648,6.542;P=0.001,<0.001).There was no statistically significant difference in the best corrected visual acuity(Log MAR)of the phacoemulsification group 0.35±0.10 and laser group 0.33±0.09 before surgery(t=0.855,P=0.396).At 3months after operation,the best corrected visual acuity of the phacoemulsification group was significantly improved(t=11.829,P<0.001)that of the laser group was not significantly changed(t=-1.710,P=0.098).The difference between the two groups was statistically significant(t=-11.296,P<0.001).At 3 months after operation,CACD(t=-30.533,P<0.001),PACD(superior,inferior,nasal and temporal)(t=-18.911,-21.389,-15.638,-20.983,all P<0.001),ACV(t=-19.205,P<0.001)and ACA(t=-16.693,P<0.001)in the phacoemulsification group were all increased compared with the preoperative level.And the anterior chamber angle was open completely.However,the improvement of anterior chamber indexes in the laser group was worse than that in the phacoemulsification group(P<0.05).Postoperative peripheral anterial synechial showed no significant improvement(c~2=0.265,P=0.607).ConclusionCompared with LPI,phacoemulsification for the treatment of PAC with cataract can reduce intraocular pressure,improve vision,significantly improve anterior chamber parameters,and make angle open.