AIM: To investigate the clinical effects of phacoemulsification combined with post chamber intraocular lens(PC-IOL)implantations for primary acute angle-closure glaucoma.

METHODS: The clinical data of 87 cases(92 eyes)with primary acute angle-closure glaucoma complicated with cataract of which intraocular pressure(IOP)over 45.0mmHg were collected. Phacoemulsification and PC-IOL implantations were performed for 60 eyes which IOP was controlled to 25.0mmHg below by general and topic medical management. IOP of 25 eyes was over 30.0mmHg and the depth of anterior chamber was well, puncture of anterior chamber was performed to decrease the IOP. Then 1 day to 2 days later, phacoemulsification, PC-IOL implantations and goniosynechialysis were performed. IOP of 7 eyes were still over 35.0mmHg with shallow of anterior chamber, phacoemulsification and PC-IOL implantation combined with goniosynechialysis and paracentesis anterior chamber were performed after vitreous aspiration and puncture of anterior chamber. IOP, visual acuity, surgery complications, central anterior chamber depth and gonioscopie findings before and post operation were recorded and analyzed.

RESULTS: The IOP of all cases was controlled under 20.0mmHg during the follow-up 6 months to 2 years. 2% carteolol hydrochloride only need for two cases after 6 months. The visual acuity were improved for most cases, the visual acuity were better than 0.3 of 65 eyes post-operation while all were lower than 0.3 pre-operation. The depth of anterior chamber was deeper in all cases and the anterior chamber angle opening range was more than 180 degree in 87 eyes. More than 60 cases suffered the complications of anterior chamber inflammation and 16 cases anterior fibrinous exudates.

CONCLUSION: Phacoemulsification is safe and effective in management of primary acute angle-closure glaucoma complicated with cataract. Goniosynechialysis, paracentesis anterior chamber and vitreous aspirations were benefit for the patient whose IOP was uncontrolled before surgery.