Management of primary angle closure glaucoma with cataract extraction

Background: We investigate the clinical result of phacoemulsification with foldable posterior chamber intraocular lens (PC-IOL) implantation in the management of primary angle closure glaucoma with cataract. Methods: We performed phacoemulsification with foldable PC-IOL implantation in the eyes with primary angle closure glaucoma and cataract. Eyes were divided in three groups. In the first group were eyes with primary acute-closed angle glaucoma with no PAS (peripheral anterior synechiae). In the second group were eyes with primary chronic angle-closure glaucoma with less than 180° of PAS. In the third group were eyes with primary chronic angle-closure glaucoma with more than 180° of PAS seen on gonioscopic examination. Results: In the first group of 15 patient mean follow up time was 10.7 month. IOP change from mean 58 mmHg to mean 13.5 mmHg postoperative. ACD change from 2.31 mm to 3.67 mm postoperative. Best corrected visual acuity change from 0.25 to 0.7 postoperative. In the second group of 30 patient mean follow up time was 15.9 months. IOP fall from mean 19.9 mmHg to mean 12.1 mmHg postoperative. ACD change from 2.45 mm to 3.93 mm postoperative. Best corrected visual acuity change from 0.4 to 0.83 postoperative. In the third group of 15 patient mean follow up time was 9.6 month. IOP fall from mean 16.4 mmHg to mean 14.5 mmHg postoperative. ACD change from 2.51 mm to 4.20 mm postoperative. Best corrected visual acuity change from 0.25 to 0.54 postoperative. Conclusions: Phacoemulsification with PC-IOL implantation can be a good alternative in treating eyes with cataract and primary acute and chronic angle closure glaucoma with less than 180° of PAS seen on gonioscopic examination. With cataract surgery performing soon after diagnosing primary angle closure glaucoma we can prevent chronical disease. With this the patient quality of life is beater and with less therapy.