Phacoemulsification combined with goniosynechialysis in the treatment of cataract with acute angle-closure glaucoma

Objective To observe the clinical efficacy of phacoemulsification combined with goniosynechialysis for cataract patients with acute primary angle-closure glaucoma. Methods From February 2010 to January 2014, 54 eyes of 54 cases with cataract and acute primary angle-closure glaucoma admitted to our department were selected in this study. All patients received phacoemulsification combined with goniosynechialysis. The visual acuity, intraocular pressure, anterior chamber depth and angle changes before and after the treatment were compared. The clinical effects of this surgical approach were analyzed. Results The visual acuities 6 months after the surgery were significantly better than those before the surgery(P<0.05), and only two eyes with age-related macular diseases had poor visual acuities less than 0.1. One day after the surgery, the intraocular pressure was (13.22±3.44) mmHg (1 mmHg=0.133 kPa). One month after the surgery, the intraocular pressure was (13.87±1.11) mmHg.The intraocular pressure of three and six months after surgery were (13.81±0.97)mmHg and(13.07±1.05)mmHg respectively. Six months after the surgery, the central and peripheral anterior chamber depth were (3.53±0.32)mm and (3.91±0.14)mm respectively, both were evidently higher than those before the surgery (P<0.05). The angle grading after the surgery were improved remarkably compared with the preoperative one(P<0.05). Corneal edemas occured in six eyes, and anterior chamber inflammation and iris fibrinoid exudations occured in four eyes. The anterior chamber of two eyes were shallow. The intraocular lens were adhered to pupil in three eyes. Conclusion Phacoemulsification combined with goniosynechialysis is safe and effective for angle-closure glaucoma. This kind of combined surgery can obviously increase the depth of the anterior chamber, improve the openness of angle, improve the vision and reduce the intraocular pressure. Key words: Glaucoma, angle-closure; Phacoemulsification; Cataract; Goniosynechialysis