title: Combined phacoemulsification and nonpenetrating deep sclerectomy in the treatment of chronic angle-closure glaucoma with cataract.
abstract: OBJECTIVE
  To review the result of nonpenetrating deep sclerectomy (NPDS) combined with phacoemulsification in the treatment of chronic angle-closure glaucoma (CACG) with coexisting cataract.
  
  
  METHODS
  This is a retrospective review of 29 eyes of 26 patients who had undergone combined NPDS and phacoemulsification for cataract and CACG between January 2001 and June 2003. The visual acuity, intraocular pressure (IOP), and complications were analyzed.
  
  
  RESULTS
  The mean follow-up period was 33.8 months (range 23.3 to 54.0 months). Postoperative visual acuity improved in 21 eyes (72%) and remained the same in 6 eyes (21%). The IOP was reduced significantly from 20.3+/-3.9 mmHg (mean +/- SD) preoperatively to 15.9+/-3.1 mmHg postoperatively at last follow-up visit (p<0.001). The number of antiglaucoma medications was also reduced significantly from 2.9+/-0.8 (mean +/- SD) preoperatively to 1.0+/-1.2 at last follow-up (p<0.001). Fifteen eyes (52%) achieved complete success with IOP < or = 21 mmHg without antiglaucoma medications and 25 eyes (86%) achieved qualified success with IOP < or = 21 mmHg with or without medications at the last follow-up visit. Of the 25 eyes achieving qualified success, 24 (96%) had a reduction in the number of medications. There were 4 failures, defined as uncontrolled IOP requiring further filtering operation or oral drug treatment. Intraoperative complications included one accidental anterior chamber puncture and one iris plug intraoperatively. Postoperative complications included one choroidal effusion, three wound leaks requiring repair, and two punctate epithelial erosions. There was no shallowing of the anterior chamber, hyphema, hypotony, or infection encountered.
  
  
  CONCLUSIONS
  Combined NPDS and phacoemulsification could be a safe and effective surgical option for the management of CACG with cataract.
authors.affiliation: Department of Ophthalmology, Tung Wah Eastern Hospital, Lo Ka Chow Ophthalmic Center, 19 Eastern Hospital Road, Causeway Bay, Hong Kong, China. nyuensy@netvigator.com
authors.forename: N S Y
authors.initials: NS
authors.lastname: Yuen
authors.forename: O C C
authors.initials: OC
authors.lastname: Chan
authors.forename: S P
authors.initials: SP
authors.lastname: Hui
authors.forename: R H Y
authors.initials: RH
authors.lastname: Ching
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000959:Antihypertensive Agents / Q000627:therapeutic use; D002386:Cataract / Q000150:complications / Q000628:therapy*; D002908:Chronic Disease; D005260:Female; D005500:Follow-Up Studies; D015812:Glaucoma, Angle-Closure / Q000150:complications / Q000601:surgery*; D006801:Humans; D007429:Intraocular Pressure / Q000187:drug effects; D008297:Male; D008875:Middle Aged; D018918:Phacoemulsification / Q000379:methods*; D011183:Postoperative Complications; D012189:Retrospective Studies; D012599:Sclerostomy / Q000379:methods*; D014792:Visual Acuity
chemical_list: D000959:Antihypertensive Agents