Abstract:AIM:To observe the effect of phacoemulsification and intraocular lens(IOL)implantation combined with goniosynechialysis on corneal endothelial cells for the treatment of primary angle closure glaucoma(PACG)combined cataract, and to analyze the relative factors.
METHODS: Ninety-five eyes of 95 patients with PACG combined cataract were documented in this study. Twenty-two patients were male, and 73 were female. The age ranged from 46 to 85y old with a mean of(66±7)y. All patients were examined for endothelial cell count(ECC), intraocular pressure(IOP)and best corrected visual acuity(BCVA)1wk, 1, 2, 3 and 6mo after operation. Meanwhile, the range of anterior chamber closure and anterior chamber depth(ACD)were recorded before operation and postoperative 6mo.
RESULTS: The mean IOP was 36.1±4.3mmHg(28-42mmHg)preoperatively and 15.8±3.5mmHg(8-28 mmHg)(1mmHg=0.133kPa)6mo after operation. There was a decreasing trend in IOP after operation(t=17.173, P<0.01). There was an increased trend in BCVA after operation(Z=-8.351, P<0.01). The mean ACD was 1.95±0.34mm preoperatively and 3.11±0.33mm 6mo after operation. There was an increased trend in ACD after operation(t=11.483, P<0.01). There were 74 eyes in the range from 90° to 180° of anterior chamber and 21 eyes less than 90° before operation. There were 12 eyes in the range from 90° to 180° of anterior chamber and 83 eyes less than 90° postoperatively. The most of anterior chamber were open(Z=-9.013, P<0.01). ECC was 2 304±135 cells/mm2 before operation and 2 243±152 cells/mm2, 2 135±177 cells/mm2, 2 028±172 cells/mm2, 2 017±181 cells/mm2, 2 006±143 cells/mm2 1wk, 1, 2, 3 and 6mo after operation respectively. ECC loss rates were 2.6%, 7.3%, 12.0%, 12.5% and 13.0%. ECC had a decreased trend 2mo after operation(F=5.568, P<0.01)and then kept stable(P3mo=0.067, P6mo=0.073).
CONCLUSION: Phacoemulsification and IOL-implantation combined with goniosynechialysis is an effective method to treat PACG combined cataract. It can increase BCVA and decrease IOP. ECC decreases after operation, but it is in the normal range. It is a safe and effective operation mode.
