Clinical outcomes of cataract extraction by phacoemulsification in eyes with acute primary angle-closure

Poster Details

First Author: S.Kobayakawa JAPAN

Co Author(s):    S. Kumashiro   T. Tochikubo           

Abstract Details

Purpose:

To review the clinical outcomes of cataract extraction by phacoemulsification with intraocular lens (IOL) implantation, in eyes with acute primary angle-closure (APAC).

Setting:

Toho University, Omori Hospital

Methods:

In this retrospective case series, the database of Toho University, Omori Hospital Medical Center was searched for cases of APAC patients with cataract. The following data were collected from the database: age, sex, pre and postoperative corrected distance visual acuity (CDVA), intraocular pressure (IOP), grading for cataract, complications, additional surgery and requirement for glaucoma drugs.

Results:

Forty-two eyes were analyzed. Mean age (+/- SD) was 67.8 +/- 9.8 years (range: 45-88 years). There were 33 female and 9 male patients, with 25 right eyes and 17 left eyes. Mean follow-up duration was 725 +/- 884 days (range: 8-4509 days). In 24 eyes (57%), CDVA improved, in 16 eyes (38%), CDVA remained the same, in 2 eyes (5%), CDVA deteriorated after surgery. IOP was decreased from a mean preoperative level of 46.1 +/- 20.1 mmHg (range: 5-62 mmHg) to 12.6 +/- 3.7 mmHg (range: 4-21 mm Hg) at final follow-up. Mean preoperative grading for cataract was 2.2 (Emery-Little classification). The perioperative complications were posterior capsule rupture and zonular dehiscence in 4 eyes (9.6%). The postoperative complication was IOP peaks in 5 eyes (12%). Goniosynechiolysis (GSL) was performed in 15 eyes (35.7%) at primary cataract extraction. Trabeculectomy was performed in 2 eyes (4.8%) postoperatively. The number of glaucoma eye drops required was 0.67 +/- 1.1 (range: 0-3) at final follow-up. The IOP at final follow-up and the number of glaucoma eye drops for the GSL group was higher, also was more than those for the non-GSL group respectively (p<0.01).

Conclusions:

In APAC patients with cataract, cataract extraction by phacoemulsification can improve preoperative CDVA and IOP. Indication for GSL will be needed further investigation. FINANCIAL DISCLOSURE?: No