Two different methods for acute angle-closure glaucoma with cataract

AIM:To investigate the clinical efficacy of phacoemulsification(Phaco)and intraocular lens(IOL)implantation combined with goniosychialysis in the treatment of acute primary angle-closure glaucoma(APACG)with cataract. METHODS: In this prospective randomized clinical trial, 60 eyes of 60 patients with APACG and coexisting cataract were randomized to the control group(30 patients, 30 eyes)or the study group(30 patients, 30 eyes)and completed the trial. All the two groups were treated with phacoemulsification and intraocular lens implantation, and the control group(30 patients, 30 eyes)was combined with trabeculectomy, while the study group(30 patients,30 eyes)was treated with the goniosychialysis. All patients were followed up for 2mo. The preoperative and postoperative best corrected visual acuity(BCVA), intraocular pressure(IOP), anterior chamber depth(ACD), anterior chamber angle(ACA)and complications were compared. RESULTS: There were no statistically significant differences between the 2 groups in BCVA, IOP, ACD, ACA before surgery(P>0.05). The postoperative BCVA, IOP, ACD and re-opening anterior chamber angle(ACA)in two groups were all improved, and the differences had statistical significance(P<0.001). BCVA, ACD, re-opening ACA of research group were significantly better than those of the control group(P<0.05). The decreased IOP of the study group were more than the control group and the complications of the control group were more than the study group, but there was no statistical difference in the postoperative IOP and complications between two groups(P>0.05). CONCLUSION: The phacoemulsification and IOL implantation combined with goniosychialysis can improve the vision of patients, decrease IOP, increase ACD, and re-opening anterior chamber angle(ACA)in patients with APACG combined with cataract. It has a positive clinical effect.