Abstract：Objective To study the clinical efficacy and effective factors for chronic angle-closure glaucoma after phacoemul sification and intraocular lens implantation combined with goniosynechialysis.Methods Eighty patients (92 eyes) with chronic angle-closure glaucoma undergoing phacoemulsification and intraocular lens implantation combined with goniosynechialysis from September 2008 to December 2013 were retrospectively analyzed.Ninety-two eyes were divided into four groups based on IOP control and the range of the anterior angle closure and peripheral anterior synechiae(PAS) before operation. Group 1(G1) 42 eyes (IOP≤25 mmHg and the range of angle closure and PAS≤270 degree). Group 2(G2) 12 eyes (IOP ≤25 mmHg and the range of angle closure and PAS＞270 degree). Group 3(G3) 10 eyes (IOP>25 mmHg and the range ≤270 degree). Group 4(G4) 28 eyes (IOP>25 mmHg and the range＞270 degree). Follow-up lasted 33 months (12-60m onths). Visual acuity, IOP, cental anterior chamber depth(ACD), anterior chamber volume (ACV) and anterior chamber angle(ACA) before and after operation were analyzed.Results Compared with pre-operation, the intraocular pressure(IOP) decreased and the visual acuity, ACD, ACV and ACA improved significantly post-operation (P<0.01). The improvement of visual acuity of G1 and G2 was better than G3 and G4(P<0.01) and G3 better than G4(P<0.01),though no difference was observed between G1 and G2(P>0.05) after surgery. Excepting that the IOP of G4 was higher than normal(22.98±4.54) mmHg, which of other three groups was controlled to normal and which of G1 and G2 was lower than G3(P<0.05) and G4(P<0.01),and G3 was lower than G4(P<0.05) ,while no difference was observed between G1 and G2(P<0.05). The IOP was controlled by additional medication and surgery in 20 eyes (2 of G3 and 18 of G4).Varying severity optic atrophy was observed in all eyes and correlated to the disease course. Similar to the visual acuity, ACD of G1 and G2 was deeper than that of G3 and G4 (P<0.01), and G3 deeper than G4 (P<0.05) while no difference was observed between G1 and G2. There were no differences among all groups of ACA and ACV except that the ACA of G1 was wider than G4 (P<0.01).Conclusions Phacoemulsification and intraocular lens implantation combined with goniosynechialysis for chronic angle-closure glaucoma is a safe and effective measure, which is beneficiat to visual acuity improvement and IOP long-term controll. But the clinical effects are closely related to the controlled condition of IOP, the range of anterior chamber closure and PAS before operation and disease course.
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2016, Vol. 27 
