The aim of this study was to observe the clinical effect of phacoemulsification combined with posterior chamberintraocularlens implantation in primary angle closure glaucoma.

A total of 48 cases (60 eyes) with primary angle closure glaucoma and cataract admitted to the ophthalmology department of the General Hospital of Armed Police from August 2013 to January 2015 were studied. Among them, there were 20 males (28 eyes) and 28 females (32 eyes). The age ranged from 57 to 82 years, with an average age of (69.20±7.32) years. Patients with acute angle-closure glaucoma (34 eyes) were divided into A₁ group and chronic angle-closure glaucoma (26 eyes) into A₂ group according to the onset time. According to the range of angle adhesion, 28 eyes were divided into B₁ group and 32 eyes were divided into B₂ group. According to whether two local antihypertensive drugs can control (intraocular pressure, IOP) in normal range, 21 eyes with good control were divided into C₁ group and 39 eyes with poor control were divided into C₂ group. All patients underwent phacoemulsification combined with posterior chamber intraocular lens implantation. Three months after operation, the subjects were followed up to record intraocular pressure, best corrected visual acuity, central anterior chamber depth, angle opening distance, angle opening degree, angle adhesion range, intraoperative and postoperative complications and drug use. The data were compared by independent sample t test.

The intraocular pressure of group A₁ and group A₂ were (30.52±8.29) mmHg (1 mmHg=0.133 kPa) and (23.91±8.12) mmHg respectively before operation, and (12.3±4.21) mmHg and (17.7±4.13) mmHg 3 months after operation. After independent sample t test, the difference was statistically significant (t=3.09, 4.96; P<0.05); preoperative intraocular pressure of group B₁ and group B₂ were (20.8±4.45) mmHg and (32.59±8.16) mmHg, respectively, and intraocular pressure of group B₁ and group B₂ were (14.04±3.19) mmHg and (16.38±4.80) mmHg three months after operation. After independent sample t test, the difference was statistically significant (t=-6.81, 2.19; P<0.05); preoperative intraocular pressure in C₁ group and C₂ group were (19.8±1.05) mmHg and (34.59±7.26) mmHg respectively, and intraocular pressure in 3 months after operation were (12.04±2.19) mmHg and (18.98±2.65) mmHg respectively. The difference was statistically significant (t=9.25, - 10.25; P<0.05) by independent sample t test. The preoperative central anterior chamber depth, angle opening distance and angle opening degree were (2.01±0.31) mm, (0.14±0.05) mm and (15.6±5.36) mm for all subjects, respectively. The central anterior chamber depth, angle opening distance and angle opening degree were (3.60±0.15) mm, (0.34±0.04) mm and (34.3±3.42) mm, respectively three months after operation. Three months after operation, the central anterior chamber deepened, the angle opened distance increased and the degree of opening increased. The difference was statistically significant (t=-35.76, -24.19, -22.78; P<0.05). There was a significant difference in the angle adhesion range between the three months after operation and before operation (χ² =33.39, P<0.05). There was significant difference in the best corrected visual acuity (χ² =16.88; P<0.05) between 3 months after operation and before operation. After 3 months follow-up, the IOP control rates of A₁, A₂, B₁, B₂, C₁ and C₂ groups were 97%, 88%, 96%, 91%, 100% and 91%, respectively. In addition, in patients with primary angle closure glaucoma whose intraocular pressure was less than 30 mmHg before surgery, there is a certain correlation between the degree of intraocular pressure decline after surgery and preoperative intraocular pressure and lens arch height. The corresponding functional relationship is Y=-0.854+ 0.813X₁-1.648X₂ (X₁ is preoperative intraocular pressure, X₂ is lens arch height).

Phacoemulsification and intraocular lens implantation could reduce the IOP of primary angle-closure glaucoma(PACG) patients with goniosynechia <180° and with whose two kinds of drugscould get IOP well controlled.Preoperative IOP and lens vault are significant correlated with the degree of IOP decline, for PACG patients with preoperative IOP of less than 30 mmHg. What's more, phacoemulsification and intraocular lens implantation can improve the anterior chamber, angle and visual acuity of PACG.