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J Glaucoma. 2010 Feb;19(2):119-23. doi: 10.1097/IJG.0b013e31819d5d0c.

Effects of phacoemulsification versus combined phaco-trabeculectomy on drainage angle status in primary angle closure glaucoma (PACG).

Author information

1
Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, People's Republic of China. clemtham@hkstar.com

Abstract

PURPOSE:

To document anatomic effects of phacoemulsification versus combined phaco-trabeculectomy on drainage angle in primary angle closure glaucoma (PACG).

METHODS:

Indentation gonioscopy and ultrasound biomicroscopy were performed preoperatively, and then at 1 year after phacoemulsification alone or combined phaco-trabeculectomy in PACG patients.

RESULTS:

Seventy-two PACG eyes of 72 patients were included in this study. Thirty-eight eyes were randomized into receiving phacoemulsification alone, whereas 34 eyes had combined phaco-trabeculectomy. The mean extent of synechial angle closure was significantly reduced from 266.4 degrees to 198.9 degrees (P<0.001) by phacoemulsification alone, and from 266.0 degrees to 227.2 degrees (P=0.03) by combined surgery. The mean angle opening distance (AOD 500) measured by ultrasound biomicroscopy was significantly increased from 208.0 to 468.0 microm (P<0.001) by phacoemulsification, and from 214.6 to 344.4 microm (P<0.001) by combined surgery. The mean trabecular-ciliary process distance was significantly increased from 824.6 to 1043.6 microm (P<0.001) by phacoemulsification, and from 800.9 to 951.5 microm (P=0.01) by combined surgery. The mean anterior chamber depth was significantly increased from 1798.6 to 3528.4 microm (P<0.001) by phacoemulsification alone, and from 1781.6 to 3297.8 microm (P<0.001) by combined surgery. Phacoemulsification alone resulted in significantly greater postoperative angle opening distance 500 (P<0.001) and anterior chamber depth (P<0.001) than phaco-trabeculectomy.

CONCLUSIONS:

Phacoemulsification alone resulted in greater opening of drainage angle and greater deepening of anterior chamber than combined phaco-trabeculectomy in PACG eyes.

SYNOPSIS:

Phacoemulsification alone resulted in greater opening of drainage angle and greater deepening of anterior chamber than combined phaco-trabeculectomy in PACG eyes.

PMID:
19373107
DOI:
10.1097/IJG.0b013e31819d5d0c
[Indexed for MEDLINE]

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