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Glaucoma and cataracts are the leading causes of blindness, and surgery is an important treatment option. Patients with glaucoma have clinical characteristics such as high intraocular pressure, shallow anterior chamber and short axial length, and the ocular structure is often altered after anti-glaucoma surgery like trabeculectomy. These changes also lead to differences in the accuracy of intraocular lens(IOL)refractive calculation between cataract surgery after anti-glaucoma surgery or combined glaucoma and cataract surgery and alone cataract surgery. Meanwhile glaucoma patients' individual clinical characteristics and structural changes caused by anti-glaucoma surgery have shown differences in the impact on the predictive accuracy of IOL diopters and the type of refractive drift. This article reviews the latest research advances in the causes of refractive error(RE), the characteristics of refractive drift, and the selection of the most appropriate IOL formula for glaucoma patients undergoing cataract surgery or cataract surgery after anti-glaucoma surgery or combined glaucoma and cataract surgery.
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@#AIM: To evaluate the changes of anterior chamber structure in patients after combined surgery of glaucoma and cataract with viscoelastics injection under the sclera valve by OCT. <p>METHODS: The cataract with acute glaucoma patients who underwent combined surgery of glaucoma and cataract from 2016 to 2018 were enrolled. The patients were divided into the viscoelastics group and the control group. The anterior chamber depth(ACD), the angle opening distance(AOD<sub>500</sub>)and the trabecular iris angle(TIA)were examined to compare the changes of the anterior chamber structure between the two groups. <p>RESULTS: At 1 and 3d after surgery, the ACD(3.82±0.51,3.71±0.63, 3.78±0.33mm), the angle opening distance(AOD<sub>500</sub>: 0.25±0.04, 0.24±0.04, 0.25±0.05mm)and the TIA(25.13°±8.06°, 26.18°±8.06°, 29.25°±6.22°)were statistically different between two groups. There was no significant difference on the ACD, the AOD<sub>500</sub> and the TIA of the two groups 7d after surgery(<i>P</i><0.05).<p>CONCLUSION: Viscoelastics injection under the sclera valve can deepen the anterior chamber effectively after combined surgery of glaucoma and cataract. It avoids the occurrence of shallow anterior chamber in the early postoperation and maintains the opening of anterior chamber.
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@#AIM: To observe the curative effect of trabeculectomy combined with phacoemulsification in patients with primary angle-closure glaucoma(including acute or chronic angle-closure glaucoma)complicated with cataract and the complications influences. <p>METHODS: Sixty patients(60 eyes)with glaucoma and cataract treated in our hospital from January 2014 to July 2016 were randomly divided into control group(30 eyes)and observation group(30 eyes). Trabeculectomy were used in the control group. Trabeculectomy combined with phacoemulsification was performed in the observation group. The clinical efficacy and complication rate of the two groups were compared. <p>RESULTS: There was no significant difference in the postoperative visual acuity between the observation group and the control group(<i>P</i>>0.05). The intraocular pressure of observation group was significantly lower than that of control group(<i>P</i><0.05). In the observation group, the postoperative anterior chamber depth was greater than that in the control group(<i>P</i><0.05). The postoperative complication rate in the observation group was 7% which was significantly lower than that in the control group(23%, <i>P</i><0.05). <p>CONCLUSION: Trabeculectomy combined with phacoemulsification are the ideal treatment for primary angle-closure glaucoma with cataract. The complication rate is relatively low.
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@#AIM: To observe the curative effect of trabeculectomy combined with phacoemulsification in patients with primary angle-closure glaucoma(including acute or chronic angle-closure glaucoma)complicated with cataract and the complications influences. <p>METHODS: Sixty patients(60 eyes)with glaucoma and cataract treated in our hospital from January 2014 to July 2016 were randomly divided into control group(30 eyes)and observation group(30 eyes). Trabeculectomy were used in the control group. Trabeculectomy combined with phacoemulsification was performed in the observation group. The clinical efficacy and complication rate of the two groups were compared. <p>RESULTS: There was no significant difference in the postoperative visual acuity between the observation group and the control group(<i>P</i>>0.05). The intraocular pressure of observation group was significantly lower than that of control group(<i>P</i><0.05). In the observation group, the postoperative anterior chamber depth was greater than that in the control group(<i>P</i><0.05). The postoperative complication rate in the observation group was 7% which was significantly lower than that in the control group(23%, <i>P</i><0.05). <p>CONCLUSION: Trabeculectomy combined with phacoemulsification are the ideal treatment for primary angle-closure glaucoma with cataract. The complication rate is relatively low.
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To compare the curative effects of two surgical treatment methods for open angle glaucoma and cataract patients. ●METHODS: Totally 69 patients with primary open angle glaucoma and cataract were divided into two groups:group A and group B. Thirty- four patients (34 eyes) in group A underwent small incision non -phacoemulsification cataract surgery combined with trabeculectomy, just combined operations, 35 patients (35 eyes) in group B underwent small incision non -phacoemulsification cataract surgery beyond 6mo after trabeculectomy, just two stage operations. Postoperative intraocular pressure at 1wk and 3mo, postoperative corrected visual acuity and filtering bleb at 3mo were observed, and intraoperative and postoperative complications were compared. All the patients were followed up for 3-6mo. ● RESULTS: All the visual acuity were increased compared with that before surgery in two groups, the difference was not statistically significant. All the intraocular pressure was controlled in two groups, the difference was not statistically significant, and the difference about the filtering bleb was neither statistically significant ( P > 0. 05 ). There were no serious intraoperative and postoperative complications in two groups. ● CONCLUSlON: The two stage operations and the combined operations both can control theintraocular pressure and improved visual acuity of open angle glaucoma and cataract. The two stage operations may prevent a second operation for post trabeculectomy cataract, allowing earlier visual rehabilitation.
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AIM: To compare the effect of trabeculectomy and combined surgery of glaucoma and cataract treating primary angle-closure glaucoma ( PACG) with cataract. METHODS: It was retrospectively reviewed that 80 patients (90 eyes) with PACG and cataract were treated in our hospital from January 2012 to October 2013. They were divided into observation group ( combined surgery of glaucoma and cataract group, 45 eyes ) and control group ( trabeculectomy group, 45 eyes) . Postoperatively, all the patients were followed up for 6mo. Intraocular pressure ( IOP ) , visual acuity and complications were observed. RESULTS: Compared to preoperative IOP, postoperative IOP was significantly reduced in both observation group and control group, while IOP was reduced more greatly in observation group (P=0. 003). Visual acuity was significantly improved in observation group, while it was not improved significantly in control group ( P = 0. 036 ). Compared to control group, complications such as shallow anterior chamber with hypotony, macular edema and anterior chamber inflammation were less observed in observation group, with significant statistical difference ( P=0. 002, P=0. 003, P=0. 001). CONCLUSION: For patients with PACG and cataract, combined surgery of glaucoma and cataract is an effective surgery that can improve visual acuity and reduce IOP with fewer complications.