Ultrasound Biomicroscopy Observation Of Phacoemulsification Cataract Extraction Surgery And Intraocular Lens Mplantation For Acute Angle-closure Glaucoma Early, Sign Of Efficacy.

Objective: To observe the clinical effect of phaco emulsification and intraocular lens patient with angle closure glaucoma in the preclinical and presymptomatic phases of ultrasound biomicroscopy .Methods: 62 patients (62 eyes) with acute angle closure glaucoma in the preclinical and presymptomatic phases were studied prospective during January. 2009 to March. 2010. The patients were randomly divided into three groups. Group A received laser peripheral iridotomy. Group B received phacoemulsification and intraocular lens. Group C received phacoemulsification and intraocular lens smphyso -peripheral iridotomy. Best corrected visual acuity,intraocular pressure,postoperative complication and anterior chamber angle's related structures with UBM were observed in three groups after operation.Results: The results in the 12month after operation were as follows: The anterior chamber angle in Group A, Group B and Group C widened significantly(P<0.05), The difference in the gonioscopy grading of the anterior chamber angle among the three groups was not statistically significant(P>0.05). The anterior chamber depth and the trabecular-ciliary process distance in Group A did not change significantly(P>0.05), the angle opening distance at 500 microm from the scleral spur in Group A enlarged significantly(P<0.05), the trabecular-iris angle in Group A widened significantly(P<0.05) The anterior chamber depth in Group B and C deepened significantly(P<0.05), the angle opening distance at 500 microm from the scleral spurin Group B and C enlarged significantly(P<0.05), the trabecular-iris angle in Group B and C widened significantly(P<0.05), the trabecular-ciliary process distance enlarged significantly(P<0.05). The anterior chamber depth and the angle opening distance at 500 microm from the scleral spur and the trabecular-iris angle and the trabecular-ciliary process distance in Group A was lower than in Group B and Group C, and the difference was statistically significant(P<0.05), The difference between Group B and Group C was not statistically significant(P>0.05). The intraocular pressure in the three Groups did not change significantly(P>0.05), The variance in the intraocular pressure among the three groups was not statistically significant(P>0.05). The corrected vision in Group A did not change significantly(P>0.05), The corrected vision in Group B and Group C improved significantly(P <0.05), The corrected vision in Group A was weaker significantly than in Group B and Group C (P<0.05),There was no significant difference about the corrected vision in the Group B and Group C(P>0.05).Conclusions: 1) UBM retrieve the deficiency of the tradition investigation of gonioscope, clear display the angular dependence dissection structures in anterior and posterior chamber ,precision measurement the protomerite structure of eyes in raw state subordinate. It posses higher diagnosticvalue in discussing mechanism of glaucoma, chooseing operation manner and evaluating therapeutic effect. 2) The management of acute angle closure glaucoma in the preclinical and presymptom phases by phacomulsification and intraocular lens is effective. 3) Phacoemulsification and intraocular lens is superior to laser peripheral iridotomy on the aspects of widing the depth and the width anterior chamber angle, and improving the corrected vision. 4) It is not necessary to combine peripheral iridotomy in phacomulsification and intraocular lens.