Phacoemulsification with intraocular lens implantation combined with goniosynechialysis for cataract with angle closure glaucoma

OBJECTIVE To investigate the curative effect of phacoemulsification with intraocular lens implantation combined with goniosynechialysis for the cataract with angle closure glaucoma.METHODS Design Retrospective case study was done for 34 cases(36 eyes) of cataract with angle closure glaucoma.Intraocular lens implantation and goniosynechialysis was performed.The best visual acuity(BCVA),intraocular pressure(IOP),chamber angle(by Goldman gonioscope),anterior chamber depth(by ophthalmology A/B ultrasonic diagnostic apparatus) were compared before and after operation.In addition,complication like cornea opacity was investigated during the follow-up 3-month period.RESULTS After 1~3 month follow-up,the mean BCVA of post-operation(20/40) was obviously improved compared with pre-operation(20/333),t=-8.644,P =0.000).The primary mean IOP before operation was(34.10±7.72) mmHg.While postoperative IOP were from 7.00 mmHg to 20.00 mmHg and mean IOP was 14.85±3.89 mmHg.The IOP was obviously decreased after operation(t=16.084,P =0.000).The central anterior chamber was deepened at 3 months post-operation(3.80±0.39mm) than pre-operation(2.35 ±0.41mm,t=-21.940,P=0.000).Angle of anterior chamber pre-operation: each quadrant with narrow angle Ⅱ~Ⅲ was 32 eyes while 1~2 quadrant with narrow angle gradeⅣ was 4 eyes.However,angle of anterior chamber was widened evidently: each quadrant with wide angle or narrow angle Ⅰ~Ⅱwere 24 eyes and 9 eyes respectively.There was only one case with narrow angle grade Ⅳ of one quadrant at 3 months after surgery.CONCLUSIONS The combined surgery of phacoemulsification with intraocular lens implantation and goniosynechialysis for the cataract with angle closure glaucoma was an effective method to decrease intraocular pressure and develop visual acuity among the cases of cataract concurred with glaucoma,preclinical phrase of angle closure glaucoma and early chronic angle closure glaucoma.