Abstract:AIM: To compare the clinical efficacy of phacoemulsification combined with angle separation with trabeculectomy in the treatment of acute angle-closure glaucoma complicated with cataract.
METHODS: A total of 46 patients(60 eyes)diagnosed as acute angle-closure glaucoma complicated with cataract in our hospital from January 2016 to December 2017 were enrolled in this study. Thirty eyes were treated with phacoemulsification combined with chamber angle separation(group A). Thirty eyes were treated with trabeculectomy(group B). The visual acuity, intraocular pressure(IOP)and central anterior chamber depth were observed at preoperative and 4d, 7d, 1mo, 3mo postoperative.
RESULTS: The LogMAR visual acuity of group A(0.20±0.18)was significantly higher than that of group B(0.39±0.09)at 3mo postoperatively(P<0.05). Before operation, IOP in group A(18.3±5.0mmHg)was no difference to IOP(17.2±1.9mmHg)postoperatively(P>0.05). Before operation, IOP in group B(18.2±5.0mmHg)was significantly difference to IOP(12.4±2.1mmHg)postoperatively(P<0.05). There was a statistically significant difference in IOP between groups in 3mo after surgery(P<0.05). In group A, the preoperative anterior chamber depth(ACD)was 2.23±0.21mm. The ACD was 3.46±0.1mm at 3mo postoperatively. In group B, the preoperative ACD was 2.21±0.12mm. The ACD was 3.36±0.09mm at 3mo postoperatively. In group A, there was no significant difference between the preoperative visual field loss(6.32±1.57db)and the 3mo postoperatively(6.54±1.42db)(P>0.05). In group B, there was no significant difference between the preoperative visual field loss(6.31±1.46db)and the 3mo postoperatively(6.57±1.52db)(P>0.05).
CONCLUSION: In this study, phacoemulsification combined with angle separation and trabeculectomy are both effectively in controlling IOP of acute angle-closure glaucoma.