Comparison of phacotrabeculectomy and sequential surgery in the treatment of chronic angle-closure glaucoma coexisted with cataract.
OBJECTIVE
To compare the safety and effectiveness of phacotrabeculectomy versus sequential surgery in chronic angle-closure glaucoma (CACG) with coexisting cataract.


METHODS
One hundred and sixty-two CACG patients (162 eyes) were retrospectively analyzed. Of them, 87 patients (87 eyes) in group A had underwent phacotrabeculectomy with intraocular lens (IOL) implantation, and 75 patients (75 eyes) in group B had underwent sequential surgery with IOL implanted. Best-corrected visual acuity (BCVA), intraocular pressure (IOP), complications and anterior chamber angle (ACA) were measured.


RESULTS
Demographic characteristics of the two groups were similar. A mean follow-up period was 15±6mo (range 13 to 24mo), a mean IOP of 16.61±6.43 mm Hg in group A and 15.80±5.35 mm Hg in group B (P=0.84) at the last follow up. The Kaplan-Meier analysis revealed that the cumulative probability of success in both groups was similar (P=0.61). Anterior uveitis and hypotony were the most common complications in group A, whereas group B experienced shallow anterior chamber with trabeculectomy. With the exception of anterior uveitis, no complications occurred to 11 trabeculectomized eyes. All postoperative measurements of anterior chamber showed statistically significant differences in each group according to the preoperative data (P<0.05). However, fewer changes occurred in group B than in group A.


CONCLUSIONS
Phacotrabeculectomy and sequential surgery exhibit similar IOP reduction, visual recovery, and complications when treating CACG patients with cataract. However, for a wider ACA, phacotrabeculectomy has demonstrated higher effectiveness than sequential surgery.
Department of Ophthalmology, Daping Hospital, the Third Mlitary Medical University, Chongqing 400042, China.
Hai-Jun
HJ
Li
Department of Ophthalmology, Daping Hospital, the Third Mlitary Medical University, Chongqing 400042, China.
Jie
J
Xuan
Department of Ophthalmology, Daping Hospital, the Third Mlitary Medical University, Chongqing 400042, China.
Xiao-Min
XM
Zhu
Department of Ophthalmology, Daping Hospital, the Third Mlitary Medical University, Chongqing 400042, China.
Lin
L
Xie
anterior chamber angle; chronic angle-closure glaucoma; phacotrabeculectomy; sequential surgery