Comparison of the therapeutic effects of two surgical methods for treating primary angle closure glaucoma with cataract

Objective To study the different clinical effects between the method of peripheral iridectomy+ trabeculectomy combined with cataract extraction with small incision+ intraocular lens implantation and the method of peripheral iridectomy+ trabeculectomy combined with cataract with phacoemulsification+ intraocular lens implantation , so as to provide guidance for clinic. Methods 40 cases were randomly divided into A and B groups, and A group included 19 patients (31 eyes), while B group included 21 patients (37 eyes). A group was treated with the peripheral iridectomy+ trabeculectomy combined with cataract extraction with small incision+ intraocular lens implantation method, and B group was cured with the method of peripheral iridectomy+ trabeculectomy combined with cataract with phacoemulsification+ intraocular lens implantation method.In each group, the eye pressures, visual acuity, central anterior chamber depths of before and after treatment were compared to study the clinical effect.And after treatment, the improvement amount of eye pressure, visual acuity, central anterior chamber depths and the complication rates were compared between the two groups, so as to determine the better method. Results After treatment, the eye pressure, visual acuity, central anterior chamber depths in A group were significantly improved[(21.71±10.17)mmHg, (0.29±0.09) and (1.97±0.47)mm, t=11.12, 6.93, 17.39, all P<0.05]. The eye pressure, visual acuity, central anterior chamber depths in B group were significantly improved[(19.45±9.54)mmHg, (0.35±0.16) and (1.98±0.39)mm, t=6.52, 5.78, 17.78, all P<0.05]. After treatment, the eye pressures in A and B groups were cut down[(21.74±10.17) and (19.45±9.54)mmHg], and there was no statistical significant difference between the two groups (t=0.96, P=0.17). The visual acuity in A and B groups were improved[(0.29±0.09) and (0.35±0.16) degrees], and there was no statistically significant difference between the two groups (t=1.86, P=0.97). The central anterior chamber depths in A and B groups were improved[(1.97±0.47) and (1.98±0.39)mm], and there was no statistically significant difference between the two groups (t=0.09, P=0.54). The incidence rates of complication in A and B groups were 48.39% and 21.62%, respectively, and the difference between two groups was significant (χ2=5.44, P=0.02). Conclusion The two treatments had significant and equal clinical effects, while because of its lower incidence rate of complication, the method of peripheral iridectomy+ trabeculectomy combined with cataract with phacoemulsification+ intraocular lens implantation is more safe than the other one. Key words: Primary angle-closure glaucoma; Cataract; Small incision cataract extraction; Phacoemulsification