AIM: To study the efficacy and safety of the combined four-surgery of vitreous humour extraction, phacoemulsification cataract, artificial lens implantation, and compound trabeculectomy in managing sustained high intraocular hypertension of acute angle-closure glaucoma.

METHODS: Retrospectively analyzed the post-operation result of 62 patients(62 eyes), consisting of 26 males(26 eyes)and 36 females(36 eyes), who were diagnosed as acute angle-closure glaucoma with anterior chamber depth of shallow class-I-IIa. Their IOP were greater than 40mmHg after 48-72h being dosed at the maximum. The patients were divided into two groups with their preoperative visual acuity. The combined four-surgery of vitreous humour extraction, phacoemulsification cataract, artificial lens implantation, and compound trabeculectomy were performed on 33 patients(33 eyes)in the experimental group, while the binary-sugery of anterior chamber paracentesis and compound trabeculectomy was performed on 29 patients(29 eyes)in the control group. Post-operative visual acuity, IOP, complications and filtering bleb were observed to compare the treatment results.

RESULTS: The high IOP of all eyes were controlled after surgeries. The IOP of the four-surgery group was obviously lower than the binary-surgery group after 1wk post the surgeries(P<0.05). Both groups were observed for 6mo. Post-operative visual acuity and complete success rate of the four-surgery were distinctly better than the binary-surgery, and no distinct difference was found in complications and filtering bleb occurrence(P>0.05).

CONCLUSION: The combined four-surgery of vitreous humour extraction, phacoemulsification cataract, artificial lens implantation, and compound trabeculectomy is safe and effective in managing acute angle-closure glaucoma with extremely shallow anterior chamber and sustained high IOP. Such surgeries should be actively performed on the patients with sustained high IOP to rescue their visual acuity.