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AIM: To investigate the risk factors of primary angle-closure glaucoma ( PACG) by questionnaires.?METHODS: By 1:2 matched case-control study, we selected 30 primary angle - closure glaucoma in Department of Ophthalmology, Affiliated Hospital of Xiangnan University from January 2015 to January 2017 and other 60 cases, the latter were no common pathogenic factors of glaucoma.?RESULTS: Using SPSS 17. 0 software for statistical analysis, single factor logistic regression analysis showed that living in rural areas, the low cultural level, high blood pressure, long time use the eye, hyperopia and asthenopia, disharmony of family relationship,family members with glaucoma were eight variables associated with the onset of PACG. Multifactor conditional logistic regression analysis showed five variables associated with the onset of PACG (P<0. 05), including the place of residence, long time use the eye, hyperopia and asthenopia, family relationship.?CONCLUSION:PACG is affected by various pathogenic factors, and it is helpful to analyze risk factors to reduce the incidence of PACG.
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AIM:To observe the effect of phacoemulsification and intraocular lens ( IOL ) implantation combined with goniosynechialysis on corneal endothelial cells for the treatment of primary angle closure glaucoma ( PACG ) combined cataract, and to analyze the relative factors.METHODS: Ninety-five eyes of 95 patients with PACG combined cataract were documented in this study. Twenty-two patients were male, and 73 were female. The age ranged from 46 to 85y old with a mean of(66±7) y. All patients were examined for endothelial cell count ( ECC ) , intraocular pressure ( IOP ) and best corrected visual acuity ( BCVA ) 1wk, 1, 2, 3 and 6mo after operation. Meanwhile, the range of anterior chamber closure and anterior chamber depth ( ACD ) were recorded before operation and postoperative 6mo. RESULTS: The mean IOP was 36. 1±4. 3mmHg ( 28-42mmHg) preoperatively and 15. 8±3. 5mmHg ( 8-28 mmHg)(1mmHg=0. 133kPa) 6mo after operation. There was a decreasing trend in IOP after operation( t=17. 173, PCONCLUSION: Phacoemulsification and IOL -implantation combined with goniosynechialysis is an effective method to treat PACG combined cataract. It can increase BCVA and decrease IOP. ECC decreases after operation, but it is in the normal range. It is a safe and effective operation mode.
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? AIM: To observe the efficacy and safety of the phacoemulsification combined with goniosynechialysis and the phacoemulsification combined with trabeculectomy for angle-closure glaucoma ( ACG ) with different closure conditions accompanied with cataract.?METHODS:A total of 65 patients (70 eyes) with primary ACG accompanied with cataract were selected from those admitted in our hospital and were given phacoemulsification with goniosynechialysis ( group A, 30 patients with 33 eyes ) and the phacoemulsification with trabeculectomy ( group B, 35 patients with 37 eyes ) according to the conditions of the closed anterior angle, respectively. The two groups of patients were observed for preoperative and postoperative intraocular pressure ( IOP ) , vision, anterior chamber depth, and complications, and were followed up for 6. 5mo (6-8mo) on average.?RESULTS: Mean postoperative IOP in either group A or group B at 1mo after operation was of statistically significant difference, compared with mean preoperative IOP (P0. 05) and postoperative complications (P>0. 05).?CONCLUSION: Clinical doctors can choose appropriate treatment according to different conditions of the closed anterior angle in patients with primary angle- closure glaucoma.
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?AIM:To investigate the measurement of central anterior chamber depth ( ACD ) in patients with acute primary angle - closure glaucoma ( APACG ) with A - scan ultrasound, Pentacam and ultrasonic biological microscope ( UBM) .?METHODS: Thirty-five patients (35 eyes) with APACG were selected, of whom central ACD were measured with A-scan ultrasound, Pentacam and UBM.?RESULTS: The measurement values of ACD with A-scan ultrasound, UBM and Pentacam were 1. 5633±0. 2089, 1. 5783 ± 0. 2067, 1. 6275 ± 0. 2296mm, which was equal variance tested by the homogeneity of variance, and was significant different by multiple comparision (F=4. 074, P=0. 026). The difference of ACD between the two groups of A-scan ultrasound and UBM, A-scan ultrasound and Pentacam, UBM and Pentacam were statistically significant ( P = 0. 032, 0. 023, 0. 012 ). Altman- Bland analysis showed that the three methods were not consistent with each other.?CONCLUSION: The ACD value of the APACG with the three methods is the largest using Pentacam, followed by UBM and A - scan ultrasound. In clinical the three methods with different advantages can complement each other, but cannot be replaced. In order to obtain more accurate results, we should combine the advantage and make comprehensive analysis.
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AIM: To compared therapeutic effect of compound trabeculectomy in treatment of angle - closure and open angle glaucoma. METHODS: A total of 136 patients ( 136 eyes) with glaucoma from July 2014 to July 2015 were divided into angle-closure glaucoma (ACG) group with 72 cases (72 eyes) and open angle glaucoma ( OAG) group with 64 cases (64 eyes). All the patients were given compound trabeculectomy. The intraocular pressure, shallow anterior chamber, functional follicular and complications were compared between two groups after operation. RESULTS: The intraocular pressure of all patients were significantly decreased at 1 and 3mo after surgery. The intraocular pressure of ACG group were significantly lower than that of OAG group ( t = 11. 037, 12. 660, P CONCLUSION: Compound trabeculectomy can reduce intraocular pressure of ACG and OAG patients safely. The results in ACG patients is better than that in OAG patients.
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? AlM: To study the application value of phacoemulsification in clinical treatment of angle-closure glaucoma.?METHODS:A total of 60 cases ( 82 eyes ) , the best corrected visual acuity, anterior chamber depth, intraocular pressure, width of chamber angle and adverse reaction of patients were researched and analysed before and after treatment.?RESULTS:ln this group, 60 cases (82 eyes) compared with that before treatment, the best corrected visual acuity in patients after treatment significantly improved, with significant difference between the two groups ( P<0. 05 ); anterior chamber depth of patients before treatment were 2. 0±0. 3mm, anterior chamber depth after treatment was 4. 4 ± 1. 0mm, treatment of patients with anterior chamber depth comparison significantly improved after treatment, with statistically significant difference between the two groups ( P<0. 05 ); lOP in patients with postoperative effective control over an extended period, the difference before treatment was statistically significant ( P<0. 05 ); the width of chamber angle after treatment compared with before treatment significantly increased, with statistically significant difference between the two groups ( P < 0. 05 ); after treatment by the emergence of 5 corneal edema, 3 mydriasis, an iris atrophy, no one cases of retinal detachment.?CONCLUSlON: Phacoemulsificationin the treatment of angle - closure glaucoma has a high value, can be effectively corrected visual acuity, improve patient anterior chamber angle width and depth, a small incidence of adverse reactions.
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AlM:To discuss the clinical effect and safety of the combined surgeries of phacoemulsification and goniosynechialysis for patients with primary angle -closure glaucoma ( PACG) .METHODS:Eighty-three eyes of 83 patients with PACG and cataract were ranomized into two groups. Group A:39 patients with 39 eyes of angle-closure 0. 05). The lOP in group A was lower than that in group B 3mo after operation, there was statistical significance (P<0. 05).CONCLUSlON:Phacoemulsification and goniosynechialysis can deepen ACD significantly. This method make the anterior chamber angle open, can reduce lOP and improve the patients’ visual acuity, especially in patients with PACG. lt is a safe and effective approach to patients with PACG and cataract.
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To analyze the causes and treatments of high intraocular pressure ( > 21mmHg ) of angle - closure glaucoma underwent compound trabeculectomy 1mo after surgery. ●METHODS: This was a retrospective study of our hospital, from March 2010 to March 2013. Thirty-four (38 eyes) of angle-closure glaucoma patients were collected, who underwent compound trabeculectomy with high intraocular pressure ( > 21mmHg) 1mo after operation. We analyzed the causes and summarized the treatments. ●RESULTS:The causes which lead to early postoperative high intraocular pressure included malignant glaucoma (9 eyes of 8 cases), blood clot and connective tissue block under the scleral flap (15 eyes of 13 cases), hyphema after surgery(5 eyes of 5 cases), sclera flap incision was incarcerated with iris tissue ( 3 eyes of 3 cases ), preoperative high intraocular pressure for a long time(5 eyes of 4 cases), 1 eye of 1 case for unknown reason. After proper treatments, intraocular pressures of all patients were bellowed 21mmHg. ● CONCLUSlON: Early postoperative high intraocular pressure of angle - closure glaucoma underwent compound trabeculectomy is caused by various factors, and the early prevention and timely treatment are key points of a successful operation.
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To investigate the advantage of using the medical sodium hyaluronate gel undergo goniosynechialysis, and to compare the difference of the viscoelastic agent and perfusion fluid by clinical control study. ●METHODS:Totally 103 cases (103 eyes) patients who had angle- closure glaucoma (ACG) with cataract all in Beijing Tongren Hospital affiliated to Capital Medical University, from September 2012 to February 2013. All the patients had primary glaucoma or recurrence ACG with cataract. Their intraocular pressure (lOP) could be controlled in normal value using one or two anti -glaucoma medications. We divided all the patients into two groups by chance. Experimental group had 53 cases (50 eyes), and control group had 50 cases (53 eyes). Two groups all had been performed phacoemulsification combined with goniosynechialysis by the same experiential operator. But experimental group did goniosynechialysis using the medical sodium hyaluronate gel, control group did goniosynechialysis using perfusion fluid. We observed the change of lOP, central anterior chamber depth and anterior chamber structure of two groups in postoperative 1mo. ●RESULTS: SPSS19. 0 statistics software was utilized to analyze the data, This study selected one- side test α =0. 05, adopted paired t - test or two- sample t - test. We obtained that experimental group lOP decreased 12. 42 ± 0. 04mmHg, anterior chamber depth increased 1. 276 ± 0. 201mm; that control group lOP decreased 6. 56 ± 0. 08mmHg, anterior chamber depth increased 0. 852 ± 0. 132mm. And experimental group anterior chamber angle opened more widely than the other group, the comparison had statistical significance (P ●CONCLUSlON: ln phacoemulsification combine with goniosynechialysis,use medical sodium hyaluronate gel do goniosynechialysis can more effectively decrease lOP. This because the medical sodium hyaluronate gel has high glutinousness, it can separate angle of anterior chamber and controlling lOP effectively.
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AIM: To investigate the effect and safety of laser peripheral iridoplasty combined with iridectomy in the unmanageable acute angle - closure glaucoma by medication. METHODS:Totally 19 cases (21 eyes) with acute angle-closure glaucoma, including 15 cases ( 17 eyes ) with primary glaucoma and 4 cases (4 eyes) with intumescent cataract - induced glaucoma, were recruited into the study. The intraocular pressure ( IOP ) of all cases were still >21mmHg after 24h drug treatment, and then were treated by laser peripheral iridoplasty combined with iridectomy. The visual accurity, IOP, cornea, peripheral anterior chamber depth, anterior chamber angle and complications were observed at 24h after the surgery. RESULTS:The mean IOP of all cases was reduced from 53. 09±11. 01mmHg before the surgery to 14. 98±4. 21mmHg at 24h after the treatment, with significant statistical difference ( P CONCLUSION: Laser peripheral iridoplasty combined with iridectomy is an effective and safe method for the treatment of the unmanageable acute angle - closure glaucoma by medication.