The Clinical Analysis Of The Secondary Malignant Glaucoma After The Operation Of Angle Closure Glaucoma Combined With Age-related Cataract

Background Glaucoma and cataract are common causes of blindness. With the growing number of elderly population, the number of glaucoma combined with age-related cataract is increasing. After the intensive study, there are various ways of operation to treatment glaucoma combined with age-related cataract.3common kinds of surgical treatment are trabeculectomy only, phacoemulsification and intraocular lens implantation only, and phacoemulsification and intraocular lens implantation and trabeculectomy (phacotrabeculectomy). Although the3methods have a greater dispute, each has its own agvantages and disadvantages. Serious complications caused by any kind of treatment have a higher degree of concern, especially the occurrence of malignant glaucoma after trabeculectomy. Clinical analysis of malignant glaucoma in this paper, it is analysis of the secondary malignant glaucoma after the various operation of angle closure glaucoma combined with age-related cataract.Objective We analyzed the cases of the secondary malignant glaucoma after the operation of angle closure glaucoma combined with age-related cataract, and summarized the treatment of malignant glaucoma.Methods We selected the hospitalized patients from2009January to2013January in eye hospital of Xinxiang Medical University, and focused on looking up the clinical datum of the operation patients of the secondary malignant glaucoma which caused by various types of glaucoma combined with age-related cataract,and analyzed retrospectively those clinical datum which included the morbidity of the secondary malignant glaucoma after the operation of angle closure glaucoma combined with age-related cataract, the types of angle closure glaucoma, the induced factors and the choices of therapies for malignant glaucoma.Results1. There are896hospital patients who were gotten various types of glaucoma combined with age-related cataract during2009January to2013January, among them there are342eyes which were gotten angle closure glaucoma combined with age-related cataract had been underwent operation treatment. Among those eyes,93eyes had been underwent trabeculectomy only and129eyes had been underwent phacoemulsification and intraocular lens implantation only, and120eyes had been underwent phacoemulsification and intraocular lens implantation and trabeculectomy (phacotrabeculectomy).6cases (6eyes) caused malignant glaucoma after various operations. Those6eyes contained5cases (5eyes) caused by trabeculectomy only and1case (1eye) caused by phacoemulsification and intraocular lens implantation only.2. There are5cases (5eyes) which had been underwent phacoemulsification and intraocular lens implantation and anterior vitrectomy and mechanical goniosynechialysis.4cases (4eyes) after surgical treatment had been reached the standard of cure while1case (1eye) was ineffective after surgical treatment. In this1case (1eye), both the anterior chamber depth and intraocular pressure were not returned to normal. And then we conducted the Ahmed glaucoma valve implantation. After this surgical treatment, both the anterior chamber depth and intraocular pressure were returned to normal. Other1case (1eye) had been conducted anterior vitrectomy and mechanical goniosynechialysis and after surgical treatment it reached the cure standard. When patients discharged, the intraocular pressure of6cases of the secondary malignant glaucoma is between10and16mmHg, and the average IOP is (12.33±1.89) mmHg.Conclusions1. The secondary malignant glaucoma accounted1.75%for angle closure glaucoma combined with age-related cataract after various types of surgical therapy (6/342).2.The probability of angle closure glaucoma with combined cataract took phacoemulsification cataract and intraocular lens implantation and combined with trabeculectomy for malignant glaucoma significantly reduced. 3. The therapeutic measure of the majority of secondary malignant glaucoma is based on phacoemulsification and intraocular lens implantation and anterior vitrectomy and mechanical goniosynechialysis and we can draw up individual measures of treatment to reach the cure standard. But the only1case which needs to conduct the Ahmed glaucoma valve implantation to restore anterior chamber depth and intraocular pressure.