AIM: To observe the safety and efficacy of the 25G anterior vitrectomy surgical technique via scleral flap in phacoemulsification combined with trabeculectomy for glaucoma and cataract with extremely shallow anterior chamber.

METHODS: This retrospective case review consisted of 18 eyes of 18 patients(8 males and 10 females), of those, 11 eyes had acute angle-closure glaucoma with angle-closure greater than 180 degree, and 7 eyes had lens subluxation combined with glaucoma. All 18 patients underwent phacoemulsification, intraocular lens(IOL)implantation, trabeculectomy, and anterior vitrectomy via the scleral flap in cases where conservative management techniques cannot control intraocular pressure(IOP). The main outcomes were best corrected visual acuity(BCVA), anterior chamber depth(ACD), IOP, slit-lamp microscopic examination, number of medications, fundus examination, and complications.

RESULTS: The average axial length(AL)was 21.5±0.6 mm. Mean age was 62.3±7.9 years. Mean ACD increased significantly from 0.78±0.43 mm to 2.89±0.41 mm 1wk after surgery(P<0.001). Mean IOP decreased significantly from 43.28±9.38 mmHg to 16.72±6.28 mmHg(P<0.001). No serious complications, such as endophthalmitis, retinal detachment, suprachoroidal hemorrhage, corneal decompensation, and malignant glaucoma were observed.

CONCLUSION: 25G anterior vitrectomy via scleral flap is a safe and effective technique for glaucoma and cataract with extremely shallow anterior chamber.