AIM: To explore the change of postoperative macular structure in primary angle closure disease(PACD)complicated with cataract.

METHODS: The clinical data of 200 cases of PACD patients complicated with cataract treated in our hospital were analyzed retrospectively. The patients were divided into the Group A(n=60, 60 eyes, treated with trabeculectomy), the Group B(n=72, 72 eyes, given the phacoemulsification combined with intraocular lens implantation)and the Group C(n=68, 68 eyes, given the trabeculectomy and phacoemulsification combined with intraocular lens implantation). The vision changes before and after treatment and the changes of intraocular pressure and macular thickness(foveal area, near central area, foveal surrounding area)before operation and at 1wk, 1 and 3mo after operation were compared and observed, and the incidence of complications was compared between the two groups.

RESULTS: There were significant differences in the improvement rate and reduction rate of visual acuity among three groups at 3mo after operation(P<0.01), and the vision improvement rate in Group C was highest, while that in the Group A was the lowest. The intraocular pressure(IOP)of the three groups at 1wk, 1 and 3mo after operation was significantly lower than that before operation(P<0.05), and the IOP in the Group B was significant higher than that in the Group A and the Group C at 1wk, 1mo after operation(P<0.05), and there were significant differences in the thickness of foveal area and near central area among three groups before and after operation(P<0.05). And the macular thickness(foveal area, near central area, foveal surrounding area)in the Group A and C at 1wk, 1 and 3mo after operation was significantly thicker than that before operation(P<0.05), and the macular thickness of foveal area in the Group B was significantly thicker at 1wk and 1mo after operation than that before operation(P<0.05). And the comparison between groups showed that the macular thickness(foveal area, near central area)in the Group C at 1wk, 1 and 3mo after operation was significantly less compared with that in the Group A and the Group B(P<0.05). There were significant differences in the incidence rate of complications among three groups(P<0.01), and the incidence rate in the Group A was significantly higher than that in the Group B and the Group C(P<0.05).

CONCLUSION: Phacoemulsification combined with intraocular lens implantation can relieve angle closure caused by pupillary block and lens factors, and can significantly improve the vision and reduce intraocular pressure of PACD patients with cataract, and it has small effects on postoperative macular edema with few complications.