Clinical study of phacoemulsification with goniosynechialysis for the treatment of primary angle-closure glaucoma after trabeculectomy with complicated cataract

Objective To investgate the clinical effect of phacoemulsification combined with go niosynechialysis on primary angle-closure glaucoma after trabeculectomy with complicated cataract.Methods It was a prospective randomized clinical trial.There were 35 cases(38 eyes),diagnosed primary angle-closure glaucoma(PACG) with cataract in our hospital.All patients were undergone phacoemulsification and intraocular lens(IOL) implantation,combined with goniosynechialysis.The best corrected visual acuity(BCVA) before and after operation、intraocular pressure(IOP)、the central anterior chamber(CAC) depth and the change of anterior chamber angle were all observed and reported.The time of following-up was 6 to 12 months.Results All patients BCVA were improved after operation.Preoperative mean IOP is(16.91±3.44) mm Hg,while the postoperative IOP were(11.82±2.52) mm Hg,The IOP were obviously decreased after operation(P0.05).Preoperative mean CAC depth is(2.10±0.19)mm,while the postoperative CAC depth were(3.31±0.28)mm,The CAC depth were obviously decreased after operation(P0.05).There were 29 eyes whose preoperative CAC depth were less then 1/2CT.There were 28 eyes whose postoperative CAC depth were more than 1CT.The angle-closure can be partly opened.Iris adhesion around the significant reduction.2 cases anterior chamber bleeding,3 cases cellulose sexual exudate in the anterior chamber.Posterior capsular rupture occurred in 1 eye,no malignant glaucoma,corneal decompensated complication.Conclusion The threatment of primary angle-closure glaucoma after trabeculectomy with cataract by phacoemulsiflcation combined with goniosynechialysis can be reduce intraocular pressure,improve visual acuity.