Clinical analysis of raised intraocular pressure after phacoemulsification combined with goniosychialysis for the treatment of angle-closure glaucoma

Objective To discuss the cause and clinical treatment of raised intraocular pressure after phacoemulsification combined with goniosychialysis for the treatment of Angle-Closure Glaucoma. Methods Prospective analysis of 253 primary angle closure glaucoma cases (266 eyes) after the treatment of phacoemulsification combined with goniosychialysis during January 2013 to December 2014 in our hospital, of which IOP, best corrected visual acuity, visual field, central anterior chamber depth, and the change of configuration about anterior chamber angle were observed preoperatively, 1 week, 1 month and 6 months after surgery. Results High intraocular pressure was observed in 22 cases during different periods after phacoemulsification combined with goniosychialysis, in which anterior chamber angles were successfully separated and remain open in 8 cases; anterior chamber angles were temporarily separated but soon closed again in 8 cases; and anterior chamber angles failed to open in 6 cases. All 22 patients with raised intraocular pressure were successfully controlled again, the visual acuity and visual field had no significant damage. Conclusions Phacoemulsification combined with goniosynechialysisis is an effective method for the pure pupillary block angle closure glaucoma, but for non pupillary block angle closure glaucoma and multiple mechanism angle closure glaucoma with long course of disease, there are higher risk of postoperatively raised intraocular pressure. We should carefully analyze the reason, and take the corresponding solution for treatment. Key words: Glaucoma; Angle-closure; Phacoemulsification; Goniosychialysis