ABSTRACT
@#AIM: To observe the safety and efficacy of phacoemulsification combined with goniosynechialysis in treatment of primary angle-closure glaucoma(PACG)with intraocular pressure out of control after trabeculectomy.<p>METHODS: We retrospectively reviewed 31 cases(32 eyes)of acute or chronic PACG with uncontrolled intraocular pressure from June 2015 to April 2019. The history of trabeculectomy was 3mo to 12a. All of them were complicated with different degrees of cataract. Phacoemulsification combined with intraocular lens implantation and goniosynechialysis were performed in all patients. The patients were followed up for 6mo. The IOP, the best corrected visual acuity(BCVA), the depth of central anterior chamber and the peripheral anterior synechia(PAS)of anterior chamber angle were observed preoperatively and 1, 3 and 6mo postoperatively. The corneal endothelial cell count and the thickness of the retinal nerve fiber layer(RNFL)were observed 6 months after the operation. The complications during and after operation were observed. <p>RESULTS: The IOP was significantly decreased on 1wk, 1, 3, 6mo postoperative(14.38±3.04, 18.26±3.12, 15.21±2.84, 15.42±3.09mmHg)compared with preoperative(36.52±12.26mmHg)(<i>P</i><0.01). The BCVA(LogMAR)(0.241±0.148)was increased postoperative after 6 mo compared with preoperative(0.678±0.297). The depth of central anterior chamber was increased on 1, 3, 6mo postoperative(4.18±0.22, 4.21±0.24, 4.16±0.25mm)compared with preoperative(1.45±0.25mm). All of above observation indexes was significantly different from that of preoperation(<i>P</i><0.01). The angle of anterior chamber was widened and the range of PAS was reduced. The PAS did not increase after 3mo. There was no statistical difference between preoperative and postoperative about the corneal endothelial cells count and the mean or the four quadrant RNFL thickness(<i>P</i>>0.05). Corneal edema in 7 eyes and anterior chamber inflammatory exudation in 3 eyes disappeared within 7d after treatment. The IOP of 3 patients(3 eyes)with chronic PACG was 21-30mmHg which was controlled by 1 to 3 anti-glaucoma eye drops.<p>CONCLUSION: Phacoemulsification combined with goniosynechialysis is a safe and effective method in the treatment of PACG combined with cataract with intraocular pressure out of control after trabeculectomy.
ABSTRACT
AIM: To observe the therapeutic effect and safety of improved extra panretinal photocoagulation ( E - PRP) in the treatment of high risk proliferative diabetic retinopathy (hsPDR). METHODS: A total of 88 consecutive cases (102 eyes) with hsPDR were diagnosed by fundus fluorescein angiography(FFA) from February 2011 to December 2014 in our hospital . Fifty two eyes had been treated by improved E - PRP with 532nm frequency - doubled laser. Fifty eyes had been treated by standard PRP. All cases were checked by FFA and fundus photocoagulation every 3mo. Patients with persisting neovascularization or non perfusion area were treated with laser again. All cases were followed up 6-36mo. RESULTS: The postoperative visual acuity had no statistical difference between two groups ( P > 0. 05). In improved E - PRP group, retinal non perfusion area and neovascularization disappeared in 35 eyes ( 67%). Effective rate was 88%. Six eyes (12%) underwent pars plana vitrectomy because of vitreous hemorrhage, fiberosis and stretched retinal detachment. In standard PRP group, retinal nonperfusion area and neovascularization disappeared in 23 eyes ( 46%). Effective rate was 66%. Seventeen eyes(34%) underwent pars plana vitrectomy because of anterior retina bleeding or vitreous hemorrhage. The rate of neovascularization disappeared and effective rate had statistical difference between two groups (P CONCLUSION: It is a safe and effective methods to treat hsPDR by improved E-PRP and it was more effective than traditional PRP.