Angle-closure glaucoma and cataract prospective study of efficacy of two surgical methods

Objective To compare the efficacy of phacoemulsification versus trabeculectomy for the primary angle-closure glaucoma combined with cataract.Methods Seventy-eight patients (78 eyes)with primary angle-closure glaucoma and cataract were divided into two groups randomly.Group A accepted phacoemulsification (40 eyes); group B trabeculectomy (38 eyes).All patients were followed up 3 months postoperative.IOP changes,visual acuity/angle changes were observed,and the postoperative complications and hospital stay at 1week,1 month and 3 months after the surgery were compared between the two groups.Data were analyzed using chi-square test and independent t-test.Results At 1 week after surgery,the mean IOP of group A was 11.2 ± 2.3mmHg,group B 12.1± 3.9 mmHg; the difference of the two groups was not statistically significant (P ＞0.05).By international standards,the corrected visual acuity improved ≥ 0.3 were 34 cases in group A,0 in group B,the difference of two groups was statistically significant (P ＜0.05); the corrected visual acuity improved ＜0.2 was 4 cases in both group A and B,visual acuity of another 34 cases were decreased.At 1 month after surgery,the mean IOP of group A was 12.2 ± 2.4mmHg,group B 14.2± 4.7 mmHg,the difference of the two groups was not statistically significant (P ＞0.05).By international standards,the corrected visual acuity improved ≥ 0.3 were 37 cases in group A,0 in group B,the difference of two groups was statistically significant (P ＜0.05); the corrected visual acuity improved ＜0.2 were 3 cases in group A,7 in group B,visual acuity of another 31 cases were decreased.At 3 months after surgery,the mean IOP of group A was 13.2± 3.3mmHg,group B 16.1± 4.9 mmHg,the difference of the two groups was statistically significant (P ＜0.05).By international standards,the corrected visual acuity improved ≥0.3 were 30 cases in group A,0 in group B,the difference of two groups was statistically significant (P ＜0.05),the corrected visual acuity improved ＜0.2 were 8 cases in group A,2 in group B,visual acuity of another 36 cases were decreased.The anterior chamber angle entrance measured by UBM showed,group A was increased,as 34.2 ± 4.5 °,group B 12.2± 6.1 °,the difference of two groups was statistically significant (P ＜0.05).Conclusions For the primary glaucoma patients with cataract,phacoernulsification can better control intraocular pressure,improve visual activity and reduce postoperative complications than trabeculectomy. Key words: Primary glaucoma patients with cataract;  Phacoemulsification;  Trabeculectomy