Application of phacoemulsification with laser peripheral iridoplasty for acute angle-closure glaucoma with cataract

AIM: To observe the application of phacoemulsification combined with laser peripheral iridoplasty(LPIP)for acute angle-closure glaucoma with cataract which could not be controlled well by drugs. <p>METHODS: From January 2011 to June 2015, 49 eyes in 47 patients with acute angle-closure glaucoma and cataract were recruited while their intraocular pressure remained higher than 40mmHg 12h after drug treatment. LPIP were performed and phacoemulsification and intraocular lens implantation were carried out 3d after. Their clinical data and follow-up results were reviewed. <p>RESULTS: The intraocular pressure before treatment, 1d after LPIP, 1d after phacoemulsification, 1mo after phacoemulsification and 3mo after phacoemulsification were 62.35+10.31mmHg, 17.96±4.64 mmHg, 16.58±3.19mmHg, 13.50±2.74 mmHg and 13.46±2.48 mmHg respectively(<i>F</i>=10.02,<i>P</i><0.05); the intraocular pressure of 1d(<i>t</i>=4.35), 1mo(<i>t</i>=6.43)and 3mo(<i>t</i>=6.97)after phacoemulsification were all lower than the initial pressure(<i>P</i><0.05). The visual acuity showed the same trendy, while the visual acuity before treatment, 1d after LPIP, 1d, 1 and 3mo after phacoemulsification were 0.06±0.02,0.20±0.18,0.45±0.19,0.60±0.11,0.65±0.09 respectively(<i>F</i>=8.36,<i>P</i><0.05). The best corrected visual acuity at 1d, 1 and 3mo after phacoemulsification were better than that before laser treatment(<i>t</i>=3.97, 5.12, 5.89,<i>P</i><0.05). At 1d and 3mo after phacoemulsification, the anterior chamber depth, angle opening distance, trabecular/iris angle were all better than the initial ones(<i>P</i><0.05). At 1 and 3mo after phacoemulsification, the goniosynechia got better as well(<i>P</i><0.05). <p>CONCLUSION: Phacoemulsification combined with LPIP can reduce intraocular pressure, improve the visual acuity and make the anterior chamber depth, angle opening distance, trabecular/ iris angle, goniosynechia better for patients with acute angle-closure glaucoma and cataract when drug cannot control intraocular pressure well