AIM:To evaluate the safety and efficacy of Ex-press implantation combined with phacoemulsification in primary angle-closure glaucoma(PACG)patients with cataract.

METHODS:Sixty-two cases(70 eyes)of primary angle-closure glaucoma with cataract were randomly divided into clinical trail group(34 eyes)and control group(36 eyes). The clinical trail group was treated with Ex-press miniature drainage device implantation combined with phacoemulsification and intraocular lens implantation. The control group was treated with trabeculectomy combined with phacoemulsification and intraocular lens implantation. The best corrected visual acuity(BCVA), intraocular pressure(IOP), corneal endothelium and central anterior chamber depth(ACD), complications were recorded preoperatively as well as postoperatively on day 1, 7 and at 1, 3, 6, and 12mo.

RESULTS: At the last review of trail group after operation, the best visual acuity(Log MAR)was 0.53± 0.19, which was better than the preoperative visual acuity 0.83± 0.41(P=0.001). The postoperative IOP in the clinical trail group decreased, which was 7.37±2.94, 9.88±3.18, 10.84±2.68, 12.28±2.81, 12.82±2.84 and 14.14±3.41mmHg at 1d, 1wk, 1, 3, 6, 12mo compared with the preoperative one(31.3±6.85mmHg)(P<0.05). There were no differences on postoperative IOP between the two groups(P>0.05). The ACD, corneal endothelial cell density of the clinical trail group and the control group obviously increased after operation, and the difference in ACD between the two groups after operation was not statistically significant(P>0.05). The relative success rates of the clinical trail group and the control group were 97.1% and 94.4% respectively at 12mo after surgery, and the difference was not statistically significant(P>0.05).

CONCLUSION: The operation of Ex-press miniature glaucoma drainage device implantation combined with phacoemulsification and intraocular lens implantation, which can reduce IOP and improve visual acuity evidently with less complications, is a safe and effective combined operation for primary angle-closure glaucoma with cataract.