AIM: To evaluate the changes of anterior scleral thickness in acute angle-closure glaucoma patients with high intraocular pressure(IOP)after phacoemulsification and intraocular lens implantation with ultrasound biomicroscope.

METHODS: The prospective clinical study enrolled 65 cases(72 eyes)with primary acute angle-closure glaucoma and cataract of whom IOP were all over 50mmHg. IOP of all patients were still over 45mmHg with shallow anterior chamber after general and topical medical management. Phacoemulsification and intraocular lens implantation combined with goniosynechialysis were performed after vitreous aspiration in all patients. Ultrasound biomicroscope was performed preoperatively and at 1, 6mo postoperatively. The anterior chamber depth(ACD), anterior scleral thickness(AST)and angle opening distance at 500μm from the scleral spur(AOD₅₀₀)were measured at superior, temporal, nasal and inferior to detect the changes of anterior segment parameters.

RESULTS: The ACD were 1.532±0.316, 3.337±0.652 and 3.458±0.482mm preoperatively and at 1 and 6mo postoperatively, and there were significant differences between before and postoperatively(P<0.01). The postoperative nasal and inferior AST obviously increased(P<0.05), but the postoperative superior and temporal AST increased a little(P>0.05).Compared with preoperative, the mean AOD₅₀₀ increased by 0.007, 0.006, 0.014 and 0.019mm at superior, temporal, nasal and inferior, and the differences were significant compared to those before surgeries(all P<0.01).

CONCLUSION: For acute angle-closure glaucoma patients with shallow anterior chamber and sustained high IOP and can't be managed with drugs, cataract surgery can deepen the central ACD, increase the anterior scleral thickness, and widen the anterior chamber angle. But the change of scleral thickness needs larger sample study.