AIM: To analyze the efficacy and safety of goniosynechialysis or trabeculectomy combined with phacoemulsification(Phaco)in the treatment of primary angle-closure glaucoma(PACG)and coexisting cataract.

METHODS: A retrospective study. A total of 108 eyes of 96 PACG patients with age-related cataract admitted to our hospital from March 2013 to February 2018 were collected. Goniosynechialysis combined with Phaco(group A)was performed in 50 cases(54 eyes), and trabeculectomy combined with Phaco(group B)in 46 cases(54 eyes). The best corrected visual acuity, intraocular pressure, central anterior chamber depth, corneal endothelial cell count, failure rate, recurrence rate, operation time and average hospitalization days were compared between the two groups.

RESULTS: After at least 12mo of follow-up(till February 2019), the best corrected visual acuity of the two groups was significantly improved, and the intraocular pressure was significantly lower than preoperation(P<0.01). Intraocular pressure in group B was significantly lower than that in group A postoperatively(P=0.004), while the best corrected visual acuity in group B was lower than that in group A(P=0.012). The central anterior chamber depth of the two groups was significantly deeper than pre-operation(P<0.01), but there was no significant difference between the two groups(P=0.231). At the last follow-up, there was no significant difference in the percentage of hexagonal cells(P>0.05). The operation time of group A was shorter(P=0.022), and the average hospitalization days were significantly lower than those of group B(P<0.001). There was no significant difference in the failure rate(P=0.243)and recurrence rate(P=0.113)between the two groups.

CONCLUSION: Goniosynechialysis combined with Phaco in the treatment of PACG and coexisting cataract has similar efficacy and safety to trabeculectomy combined with Phaco. The former may achieve better visual acuity, shorter operation time and shorter hospitalization time, while the latter has lower failure rate and recurrence rate, which is more suitable for patients with chronic PACG.