Effect of Cataract Extraction in Chronic Angle-closure Glaucoma Patients

ABSTRACT

PURPOSE: To investigate the effects of cataract extraction in chronic angle-closure glaucoma (CACG) patients. METHODS: Sixteen eyes from 14 patients with CACG underwent phacoemulsification with posterior chamber intraocular lens (PCL) implantation (group A), and 19 eyes from 17 patients with CACG underwent cataract surgery and additional trabeculectomy (combined surgery, group B) were evaluated for visual acuity, intraocular pressure (IOP), number of glaucoma medications and surgical complications. All patients had patent peripheral iridotomy holes before cataract surgery, and a minimum 6 month follow-up period was needed. RESULTS: The mean postoperative follow-up period was 15.6 months in group A, and 21.7 months in group B. After surgery, the IOP was significantly reduced in both groups [from 16.1 mmHg to 13.8 mmHg in group A (P=0.013), and from 16.7 mmHg to 13.2 mmHg in group B (P=0.005)], but the amount of IOP reduction was not significantly different between the two groups (P=0.401). The relative decrease in the mean number of postoperative glaucoma medications was 0.9 in group A and 1.8 in group B, but these were not significantly different (P=0.060). CONCLUSIONS: Simple cataract surgery was effective in reducing IOP as much as combined surgery in CACG patients. These results affirm that phacoemusification with PCL implantation may be considered as the first treatment in cataract and CACG patients.