Cataract extraction for primary acute angle-closure glaucoma

Objective To investigate the clinical results of cataract extraction in the management of acute episode eyes of primary angle-closure glaucoma. Methods 27 eyes (27cases) with primary acute angle-closure glaucoma and lens opacity were treated by extracapsular cataract extraction with intraocular lens implantation,and viscoelastic agents applied to separate anterior chamber angle. Results After the follow-up of 1 week and 1 month, the intraocular pressure(IOP) was reduced from a preoperative IOP of (27.85±6.84) mmHg(22eyes,IOP21mmHg; 5 eyes,IOP≤21mmHg) to a postoperative IOP of (16.52±4.60) mmHg (25eyes,IOP≤21mmHg) and that of(19.93±5.13)mmHg (22eyes,IOP≤21mmHg)respectively. Statistical significant differences were found in the mean IOP before and after the operation (1 week, 1 month). After 1 week, the better postoperative vision was in 15 cases(55.56%),no changes in 11 cases, worse in 1 case compared with preoperative. After 1 month, the better postoperative vision was in 18 cases(66.67%),no changes in 7 cases, worse in 2 cases compared with preoperative. 12 patients(44.4%) developed high IOP and shallow anterior chamber, and prolapse of iris occurred in 3 cases(11.11%) during operation. In postoperative complications, corneal edema occurred in 10 cases(37.04%),exudates of iris or the exudative membrane of preartiphakia in 10 cases(29.63%), corectasis in 7 cases(25.93%). Conclusions Extracapsular cataract extraction with intraocular lens implantation, and viscoelastic agents applied to separate anterior chamber angle can be a good alternative in treating primary acute angle-closure glaucoma with lens opacity, but the long-term efficiency should be observed.