The effect of phacoemulsification on intraocular pressure in eyes with primary angle closure glaucoma after trabeculectomy
- Author:
- No author available
- Journal Title:
- Chinese Journal of Ophthalmology
- Issue:
- 2
- DOI:
- 10.3760/cma.j.issn.0412-4081.2016.02.006
- Key Word:
- 超声乳化白内障吸除术;小梁切除术;手术后并发症;青光眼,闭角型;眼内压;Phacoemulsification;Trabeculectomy;Postoperative complications;Glaucoma.angle-closure;Intraocular pressure
Abstract： Objective To evaluate the effect of phacoemulsification on intraocular pressure (IOP) in filtered eyes with primary angle closure glaucoma (PACG).Methods In this retrospective case series,47 eyes from 47 PACG patients who previously had trabeculectomy were consecutively enrolled.All patients had visually significant cataracts and phacoemulsification was performed at least 3 months after trabeculectomy.The IOPs were recorded preoperatively,1 day,1 week,2 weeks,1 month,3 months,6 months,12 months and 24 months after surgery.The best correct visual acuity (BCVA),the number of glaucoma medications and the filtered bleb grade were recorded preoperatively and 24 months after phacoemulsification.IOP and BCVA before and after phacoemulsification were compared by student t test.The frequences of antiglaucoma medicine,bled grade and IOP control before and after phacoemulsification were compared by Mann-Whitney Test.Linear regression analysis,Pearson and Spearman were performed to assess the correlation between IOP change and other variants.Results IOP was decreased significantly fiom(18.7±6.7)mmHg(1 mmHg=0.133 kPa)at baseline to 16.4±2.0 mmHg at final follow-up(t=2.54,P=0.015).The median number of glaucoma medications was significantly decreased (P＜0.01)at 2 years postoperatively.The magnitude of IOP reduction was significantly correlated with preoperative IOP (r=0.95,P＜0.01).BCVA (LogMAR) was improved significantly at month 24 (t=5.62,P＜0.01).Filtered bleb decreased insignificantly at 2 years postoperatively (P=0.113).Complete success,qualified success and failure rates in terms of IOP were 61.7％,27.7％ and 10.6％ before surgery,89.4％,8.5％,2.1％ at 2 years postoperatively.In 29 patients with preoperative IOP≤21 mmHg,mean IOP increased insignificantly from(14.5±4.0)mmHg to (15.5 ±2.3) (P=0.195) at 2 years.In the 18 patients with preoperative IOP＞ 21 mmHg,mean IOP decreased from (25.3 ± 4.4) mmHg preoperatively to (17.8 ± 2.4)mmHg (P＜0.01).Conclusions Phacoemulsification reduces IOP and the number of glaucoma medications in previously filtered PACG eyes.The IOP remained normal in normal tension eyes after phacoemulsification in filtered PACG eyes but decreased significantly in hypertensive eyes.
- [1]梁远波,王宁利,乔利亚,等.对单纯白内障手术治疗合并白内障的闭角型青光眼的疗效评价[J].2004,(11).
- [2]中华医学会眼科学分会青光眼学组,中华医学会中华眼科杂志编辑委员会.我国原发性青光眼诊断和治疗专家共识[J].2008,(9).
- [3]洪颖,张纯,王薇.超声乳化白内障吸除术对功能性滤过泡形态和功能的影响[J].2009,(10).
- [4]Rebolleda G,Munoz Negrete FJ.Phacoemulsification in eyes with functioning filtering blebs: a prospective study.[J].2002,109(12).
- [5]Derbolav A,Vass C,Menapace R,etc.Long-term effect of phacoemulsification on intraocular pressure after trabeculectomy.[J].2002,28(3).
- [6]Khan MY,Manoj B,Chako D.Effect of extracapsular cataract extraction and phacoemulsification performed after trabeculectomy on intraocular pressure.[J].2000,26(1).
- [7]Mahmood U,Pacheco J,Beatty S,etc.A novel index for predicting intraocular pressure reduction following cataract surgery.[J].2005,89(5).
- [8]Sasan, Moghimi,Golshan, Latifi,Heydar, Amini,etc.Cataract surgery in eyes with filtered primary angle closure glaucoma.[J].2013,8(1).
- [9]Nguyen,D.Q.,Niyadurupola,N.,Tapp,R.J.,etc.Effect of phacoemulsification on trabeculectomy function[J].2014,42(5).
- [10]Husain R,Aung T,Gazzard G,etc.Effect of trabeculectomy on lens opacities in an East Asian population.[J].2006,124(6).
- [11]Ken Hayashi,Hideyuki Hayashi,Fuminori Nakao,etc.Changes in anterior chamber angle width and depth after intraocular lens implantation in eyes with glaucoma[J].2000,107(4).
- [12]Soltani-Moghadam, Reza,Latifi, Golshan,Moghimi, Sasan,etc.Phacoemulsification Versus Combined Phacoemulsification and Viscogonioplasty in Primary Angle- Closure Glaucoma: A Randomized Clinical Trial[J].2015,24(8).
- [13]WuDunn D,Capistrano AP,Cantor LB,etc.Effect of temporal corneal phacoemulsification on intraocular pressure in eyes with prior trabeculectomy with an antimetabolite.[J].2004,111(4).
- [14]Park SW,Heo H,Yang KJ.Comparison of ultrasound biomicroscopic changes after glaucoma triple procedure and trabeculectomy in eyes with primary angle closure glaucoma.[J].2009,18(4).
- [15]Zhuo YH,Wang M,Li.Phacoemulsification treatment of subjects with acute primary angle closure and chronic primary angle-closure glaucoma.[J].2009,18(9).
- [16]Schmitz B,Klink T,Klink J,etc.Filtering bleb function after clear cornea phacoemulsification: a prospective study.[J].2005,89(5).
- [17]Sihota R,Agarwal HC,Gupta V.Long-term evaluation of trabeculectomy in primary open angle glaucoma and chronic primary angle closure glaucoma in an Asian population.[J].2004,32(1).
- [18]Monika Sałaga-Pylak,Małgorzata Kowal,Tomasz Żarnowski.Deterioration of filtering bleb morphology and function after phacoemulsification[J].2013,13.
- [19]Sudarshan Khokhar,Narottama Sindhu,Mayank S Pangtey.Phacoemulsification in filtered chronic angle closure glaucoma eyes[J].2002,30(4).
- [20]Kirker AW,Crichton AC.Intraocular pressure and medication control after clear corneal phacoemulsification and AcrySof posterior chamber intraocular lens implantation in patients with filtering blebs.[J].2001,10(1).
- [21]Samuelson TW,Lindstrom RL,Poley BJ,etc.Intraocular pressure reduction after phacoemulsification with intraocular lens implantation in glaucomatous and nonglaucomatous eyes: evaluation of a causal relationship between the natural lens and open-angle glaucoma.[J].2009,35(11).
- [22]Greve EL,Gunning FP.Lens extraction for uncontrolled angle-closure glaucoma: long-term follow-up.[J].1998,24(10).
- [23]Pia Ehrnrooth,Ilkka Lehto,P<img src="http://onlinelibrarystatic.wiley.com/undisplayable_characters/0000e4.gif" alt="[a WITH DIAERESIS]" />ivi Puska,etc.Phacoemulsification in trabeculectomized eyes[J].2005,83(5).