Phacoemulsification, Viscosynechiolysis, and Trabeculectomy after Initial Management of Acute Primary Angle Closure: A Comparative Study
Amin Zand1 *, Mahdi Sharifzadeh Kermani1 , Mina Haj-mohammad Karimi1 , Ali Sharifi1 , Mahla Shadravan1 , Arash Daneshtalab1
- Department of Ophthalmology, Shafa Hospital, Kerman University of Medical Sciences, Kerman, Iran
Abstract: The aim of this study was to assess the effects of phacoemulsification, viscosynechiolysis, and trabeculectomy on patients with a recent history of APAC.
Methods: In this prospective nonrandomized study, we enrolled patients with cataracts, PAS, and a history of APAC attack managed with medications and laser peripheral iridotomy (LPI) within 6 weeks. Patients without signs of glaucomatous optic neuropathy underwent phacoemulsification and viscosynechiolysis (PV group). Trabeculectomy was added to this procedure for cases with glaucomatous optic neuropathy (PVT group). We evaluated best-corrected visual acuity (BCVA), intraocular pressure (IOP), angle opening, PAS extension, and adverse events at baseline and 6 months post-surgery.
Results: The PV, and PVT groups comprised 8, and 12 eyes, respectively. At month 6, both the PV and PVT groups showed significant improvement in BCVA, reduced IOP, and increased Shaffer grading scores compared to baseline (all Ps < 0.05). Extensive PAS significantly decreased at month 6 in both the PV (P = 0.008) and PVT (P = 0.002) groups compared to baseline.
Conclusion: Combined phacoemulsification and viscosynechiolysis may yield similar outcomes in terms of angle opening and extensive PAS reduction compared to adding trabeculectomy in patients with cataracts and a recent history of APAC.
