Clinical study on the treatment of primary angle-closure glaucoma with cataract by phacoemulsification combined with goniosynechialysis

Objective To investigate the clinical effect of phacoemulsification combined with goniosynechialysis on primary angle-closure glaucoma with cataract. Methods It was a retrospective study.There were 20 cases (22 eyes) diagnosed primary angle-closure glaucoma (PACG) with cataract in our hospital from 2007 to 2009. Male, 12 cases (14 eyes) and female, 8 cases (8 eyes). Their age were from 64to 85 years old, mean age is 76.8 gears old. 22 eyes:18 with PACG, 4 with CPACG, were undergone phacoemulsification and IOL implantation, combined with goniosynechialysis. The intraocular pressure (IOP)before and after operation, best corrected visual acuity ( BCVA), peripheral anterior chamber (PAC) and the change of anterior chamber angle were all observed and reported. The time of following up was 3 to 12months. Results preoperative IOP were from 7.8 mmHg to 30 mmHg and mean IOP is 18. 91 + 5.48mmHg. Meanwhile the postoperative IOP were 11.81+2.9 mmHg. The IOP were obviously decreased after operation. The IOP were obviously decreased after operation. There were 7 eyes (31.8%) whose preoperational BCVA were less than 0.1. There were 12 eyes (54.5%) whose postoperative BCVA were more than 0. 5, There were 18 eyes whose preoperative PAC depth were less than 1/2 CT. There were 22 eyes whose postoperative PAC depth were more than one CT. They have smooth iris and disappeared peripheral bulges.The angle-closure can be partly opened and the range of goniosynechia can be decreased after operation. Two cases had anterior chameber angle exudative and iris adhesion. Only one case had posterior capsular rupture.No case had corneal decompensation. Conclusion The treatment of primary angle-closure glaucoma with cataract by phacoemulsification combined with goniosynechialysis phacoemulsification combined with goniosynechialysis is safe and effective. Key words: phacoemulsification;  goniosynechialysis;  primary angle-closure glaucoma;  cataract