The changes of anterior chamber angle and the choice of surgical procedure in different intraocular pressure of acute angle-closure glaucoma

Objective:To evaluate the efficacy and safety of phacoemulsification and phacotrabeculectomy for acute primary angle-closure glaucoma with the change of anterior chamber angle with different intraocular pressure(IOP).Methods:Retrospectively analyzed 135 eyes(105 cases) with acute primary angle-closure glaucoma were retrospectively analyzed from April 2005 to June 2008.Each eye was examined by gonioscopy and ultrasound biomicroscopy(UBM) with different IOP.Different methods of surgery including phacoemulsification and phacotrabeculectomy bind with foldable intraocular IOLs implantation were performed for every eye based on the changes of anterior chamber angle with different IOP.Antibiotic and glucocorticoid medicine was used in each case.All eyes were examined after 6 to 24 months.Results:The anterior chamber angle of each eye with high IOP was closed,Configuration of peripheral iris was S,site of iris insertion was AC(Spaeth classification).The anterior chamber angle was reopened in some eyes with medicine treatment.The visual acuity(VA) was improved and post operatively IOP was controlled within 20 mm Hg(1 mm Hg=0.133 kPa).Gonioscopy and UBM showed that anterior angle was widen than that before operation in two groups.No sever intraoperative and postoperative complications happened in two groups.No changes of anterior angle were observed after 6 months with that after 1 week postoperatively after 6 to 24 months.Conclusion:According to different ocular hypertension morphological changes of anterior chamber angle,take a different surgical procedures for acute angle-closure glaucoma,the postoperative results and stability can be achieved.