›› 2010, Vol. 30 ›› Issue (11): 1364-.doi: 10.3969/j.issn.1674-8115.2010.11.011

• Original article (Clinical research) • Previous Articles     Next Articles

Management of acute angle-closure glaucoma by phacoemulsification combined with goniosynechialysis

ZHENG Yan1,2, WANG Zhao-yang2, ZHU Zhao-rong2   

  1. 1.Wenzhou Medical College, Wenzhou 325027, China；2.Department of Ophthalmology, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200092, China
  • Online:2010-11-25 Published:2010-11-29
  • Supported by:

    Shanghai Key Discipline Construction Project, The Third Period, S30205

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Abstract:

Objective To investigate the clinical effects of phacoemulsification combined with goniosynechialysis in management of primary acute angle-closure glaucoma complicated with cataract. Methods The clinical data of patients with primary acute angle-closure glaucoma complicated with cataract were collected, and those (32 eyes) who received phacoemulsification combined with goniosynechialysis for uncontrolled intraocular pressure after general and topic medical management were selected. Operations were conducted within 72 h after acute episode for 29 eyes, and the other 3 eyes were operated 120 h after acute episode. The operation procedure was reviewed, and gonioscopic findings of the last follow up were recorded. Parameters of anterior segment structures of eyes including intraocular pressure, visual acuity, central anterior chamber depth, anterior chamber volume and anterior chamber angle width of examinations before operation and in last follow up after operation were analysed. Results Gonioscopy of last follow up revealed that iris root was flat, angle of anterior chamber was open, and there was much pigment on the surface of trabeculum. The angle of anterior chamber in 24 of the 32 eyes was totally open, with operations within 72 h after acute episode. Intraocular pressure was >50 mmHg (1 mmHg=0.133 kPa) in all the 32 eyes before operation, the mean intraocular pressure was (15.3±5.0) mmHg in the last follow up, the intraocular pressure was <21 mmHg in 28 eyes (all were performed operations within 72 h after acute episode), and the intraocular pressure was 21 to 27 mmHg in the 4 eyes. The last follow up after operation revealed that the best corrected visual acuity significantly elevated from that preoperation (the optimal corrected vision was <0.1 in those with operations 120 h after acute episode). Parameters of anterior segment structures of eyes after operation were significantly better than those before operation (P＜0.001). Conclusion Phacoemulsification combined with goniosynechialysis is effective in management of primary acute angle-closure glaucoma complicated with cataract, while the opportunity and indication of surgery should be properly determined.

Key words: phacoemulsification, goniosynechialysis, glaucoma, acute angle-closure