Evaluation Of Phacoemulsification With Intraocular Lens Implantation For Patients With Primary Angle-closure Glaucoma

Background:Glaucoma is the second blinding eye disease in the world, which caused the large loss to society and family. The visual function damage caused by the Glaucoma is still the focus of the blindness prevention and control. The study is researching whether the phacoemulsification combined with intraocular lens implantation fit for primary angle-closure glaucoma patients and providing more references for clinic.Objective:To observe the clinical efficacy of curing primary angle-closure glaucoma with phacoemulsification combinedwith intraocular lens implantation.Method:40primary angle-closure glaucoma coexisting cataract patients (46eyes) from April2011to April2013in our hospital ophthalmology, including primary acute angle-closure glaucoma preclinical14, acute stage16, primary chronic angle-closure glaucoma16,all need operate phacoemulsification combinedwith intraocular lens implantation.Observe index:Preoperative and postoperative the best corrected visualacuity> anteriorchamber^ACD^intraocularpressure、vision、Visual Field and so on. Gonioscopy and UBM check anteriorchamber,UBM measure depth of anteriorchamber, Goldman check intraocularpressure, Visual Field Analyzer Humphrey740i check vision. Patients were followed up3-6months, respectively, after1day,1week,1month, March, June.All the data for statistical analysis using SPSS19.0software package.Results:1. Best corrected visual acuity:40eyes(86.96%) postoperative best corrected visual acuity improved (P<0.01), primary acute angle-closure glaucoma preclinical14, acute exacerbation of13, primary chronic angle-closure glaucoma13.32(69.56%)of them corrected visual acuity>0.5, Mann-Whitney U test,comparing preoperative visual acuity with postoperative visual acuity by Mann-Whitney U testing,find Z＝5.094, P=0.000, the difference is statistically significant.2. Anteriorchamber:46eyes (100%) who had lens-induced angle closure had varying degrees of angle closure case open. Postoperative32eyes angle opened completely, closure range(0°～90°)8eyes, closure range(90°～180°)6eyes; comparing postoperative angle, postoperative acute eyes opening are better than chronic eyes(P<0.01, the difference is statistically significance). Preoperative and postoperative angle closure range comparison, Z=-8.201, P=0.000), the difference is statistically significance.3.Anterior chamber depth:Postoperative46eyes anterior chamber depth have improved obviously than preoperative situation. Primary acute angle-closure glaucoma preclinical14eyes preoperative average anterior chamber depth is (2.44±0.05) mm, postoperative average depth is (4.08±0.34) mm (P=0.0000), acute stage16eyes preoperative average anterior chamber depth is (2.34±0.05) mm, postoperative average depth is (3.95±0.14) mm (P=0.0000), primary chronic angle-closure glaucoma16eyes preoperative average anterior chamber depth is (2.89±0.11) mm, postoperative average depth is (4.13±0.15) mm (P=0.0000), comparing preoperative anterior chamber depth with postoperative situation among3groups. The difference is statistically significant (P <0.01).Comparing postoperative anterior chamber depth among3groups, find F=0.838, P=0.672(there is no statistically significant).4.Intraocular pressure:Postoperative46eyes intraocular pressure decreased compared to the preoperative pressure, primary acute angle-closure glaucoma preclinical14eyes preoperative average intraocular pressure is (19.03±2.67) mmHg, postoperative6months late average intraocular pressure is (14.72±0.63) mmHg (P=0.001).acute stage16eyes preoperative average intraocular pressure is (46.80±9.86) mmHg, postoperative6months late average intraocular pressure is (15.34±0.91)mmHg,(P=0.007). the difference is statistically significant.primary chronic angle-closure glaucoma16eyes preoperative average intraocular pressure is (28.94±7.34) mmHg, postoperative6months average intraocular pressure is (14.47±1.52) mmHg,(P=0.001). The difference is statistically significant. Comparing preoperative intraocular pressure with postoperative situation among3groups the difference is statistically significant (P<0.01)Conclusion:Phacoemulsification combinedwith intraocular lens implantation curing primaryangle-closureglaucoma can not only make vision improved、intraocular pressure decreased%Anteriorchamber opened, but also avoid complications caused by filtering operation such as shallowanteriorchamber、choroidaldetachment、malignantglaucoma and improve surgical successrate.