AIM: To analyze the clinical effect and security of phacoemulsification combining goniosynechialysis to treat cataract accompanied with acute angle-closure glaucoma.

METHODS: The clinical data of totally 45 patients(48 eyes)with cataract and acute angle-closure glaucoma was retrospectively analyzed, including 28 patients(30 eyes)treated with phacoemulsification with goniosynechialysis(the study group)and 17 patients(18 eyes)treated with phacoemulsification with trabeculectomy(the control group). The visual acuity, intraocular pressure, iridocornealis, central anterior chamber depth and complications were compared between groups.

RESULTS: Before surgery, there was no significant difference in best corrected visual acuity and iridocornealis angle between groups(P>0.05). At 7d, 1mo, 3mo, 6mo and 1a after surgery, the best corrected visual acuity of both groups increased, and the study group was higher than the control group; the iridocornealis angle close degree of both groups decreased, and the study group was lower than the control group(P<0.05). Both groups and time had an effect on intraocular pressure and chamber depth of patients(P<0.05), and there was no reciprocal action between the two factors(P>0.05). Compare in groups: 7d, 1mo, 3mo, 6mo and 1a after surgery, the intraocular pressure of both groups decreased, and at 3mo, 6mo and 1a after surgery, the study group was lower than that at 7d after surgery(P<0.05), the control group was similar to that at 7d after surgery(P>0.05). At 7d, 1, 3, 6mo and 1a after surgery, the chamber depth of both groups were higher than 1d before surgery, 3, 6mo and 1a after surgery, the study group was similar to that at 7d after surgery(P>0.05), the control group after 12mo was lower than that at 7d after surgery(P<0.05). Compare between groups: Before treatment, 7d, 1, 3 and 6mo after treatment, there was no significant difference between groups in intraocular pressure(P>0.05); at 1a after surgery, IOP of the study group was lower than the control(P<0.05). Before treatment, there was no significant difference between groups in anterior chamber depth(P>0.05); at 3, 6mo and 1a after surgery, the study group was higher than the control group(P<0.05).

CONCLUSION: Phacoemulsification combined with goniosynechialysis is effective to treat acute angle-closure glaucoma, with prominent long-term efficacy and the risk is not increased.