Effects of Phacoemulsification Combined With Goniosynechialysis on Primary Angle-closure Glaucoma.

PURPOSE: To assess the effects of phacoemulsification, intraocular lens implantation, and goniosynechialysis on patients with primary angle-closure glaucoma and cataract.

METHODS: A total of 145 eyes of 133 consecutively recruited patients were randomly divided into Phaco group and Trab group. Ocular parameters were measured before and after surgery.

RESULTS: The mean follow-up period was 13.2±5.6 months. The visual acuity in the Phaco group was significantly improved, whereas no alternation was found in the Trab group after surgery. The intraocular pressure (IOP) had no notable difference in 2 groups before surgery. Compared with preoperative IOP, there was significant decrease after surgery. No remarkable change in the IOP was measured in the 2 groups after surgery for 12 months. The anterior chamber depth was markedly augmented in the Phaco group compared with the Trab group after surgery for 3 months. Compared with the the Trab group, no obvious change in coefficient of outflow facility was found in the Phaco group before and after surgery, whereas there was a significant increase relative to its preoperation. The angle closure decreased from (290±25) to (60±35) degrees after surgery for 12 months in the Phaco group and no significant alteration was observed in the Trab group. The reduction extent of peripheral anterior synechiae was in direct proportion to the decreasing level of angle closure in the 2 groups. The change in the corneal endothelial cell density had no significant difference between 2 groups before and after surgery.

CONCLUSIONS: The treatment of phacoemulsification, intraocular lens implantation, and goniosynechialysis is safe and effective for patients with primary angle-closure glaucoma and cataract.