First Author: W.Qiang CHINA
Co Author(s):
Purpose:
To compare the ultrasound biomicroscopic changes and clinical outcome of phacoemusification alone and combined phaco-trabeclulectomy in primary angle closure glaucoma (PACG) with cataract.
Setting:
Department of Ophthalmology, Six People? s Hospital Affiliated of Shanghai Jiaotong University, Shanghai, China.
Methods:
Fifty-five eyes of 44 patients with primary angle closure glaucoma (PACG) and cataract which were enrolled in this study, were randomly divided into 2 groups, and group 1 included 24 eyes of 20 patients which received phacoemilsification alone, and group 2 was the other 31 eyes of 24 patients which received combined phaco-trabeclulectomy. Anterior segment parameters such as anterior chamber distance (ACD), angle opening distance 500 (AOD500), trabecular iris angle (TIA),angle recess area (ARA)and trabecularciliary processes distance (TCPD) were measured by ultrasound microscopy preoperatively and at 6 months postoperatively respectively. Other outcome measures included best-corrected visual acuity (BCVA), intraocular pressure(IOP), corneal endothelial cell density, and the number of the antiglaucomatous mediation, as well as the main complications in the early period after surgery
Results:
The mean BCVA improved, and the mean IOP was significantly reduced at 1 week, 1 month, 3 months, and 6months postoperatively, than those preoperatively (P<0.01) in group 1and group 2. The mean ACD, AOD500, TIA and ARA at 6 months postoperatively were significantly different from those preoperatively (P<0.01), except for TCPD (P>0.05) in both groups. The mean corneal endothelial cell at 6 months postoperatively had a significant difference from that preoperatively (P>0.05), and the mean kinds of antiglaucomatous medication decreased at 6 months postoperatively compared to preoperatively(P<0.01) in both groups. The main complications in the early period after surgery in group 1 were corneal edema, and exudative membrane in pupil, and in group were anterior chamber hemorrhage and choroid detachment. In addition to above mentioned.
Conclusions:
Phacoemulsification alone and combined phaco-trabeclulectomy performed on the patients with PACG and cataract can both effectively deepen the anterior chamber, eliminate the papillary block, remend the configuration of the anterior chamber angle, and increase the faculty of the drainage of the aqueous outflow , as well, the IOP was well controlled postoperatively. While combined phaco-trabeclulectomy resulted more surgical complications. FINANCIAL DISCLOSURE?: No
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