Effects of Combined Phacoemulsification and Viscogoniosynechialysis versus Trabeculectomy in Patients with Primary Angle-Closure Glaucoma and Coexisting Cataract

Aims: To compare the effectiveness of combined phacoemulsification and viscogoniosynechialysis versus trabeculectomy alone in primary angle-closure glaucoma (PACG) with a coexisting cataract. Methods:Thirty-nine Chinese patients (39 eyes) were retrospectively analyzed: 19 patients underwent combined phacoemulsification and viscogoniosynechialysis (group 1), and 20 underwent trabeculectomy (group 2). In both groups, the intraocular pressure (IOP), the number of antiglaucoma medications, the best corrected visual acuity (BCVA), the central anterior chamber depth (ACD), the synechial/apposition angle closure (SAC), and the success rates were assessed. Results:The median follow-up periods were similar for both groups (10 months). At the last follow-up, the mean IOP was 14.09 +/- 6.89 mm Hg and the mean number of antiglaucoma medications was 0.36 +/- 0.59 in group 1; in group 2, the mean IOP was 16.48 +/- 4.74 mm Hg (p = 0.066) and the mean number of antiglaucoma medications was 1.05 +/- 0.99 (p = 0.025). In terms of the mean central ACD and the mean SAC, there were significant differences between the groups (p = 0.0000, respectively). Kaplan-Meier analysis revealed that the cumulative probability of success in group 1 was higher than that in group 2 (p = 0.0051). Conclusion: Compared to trabeculectomy, combined phacoemulsification and viscogoniosynechialysis resulted in a lower requirement for glaucomatous medications, a greater improvement in BCVA, and a higher cumulative probability that treatment would be successful among patients with PACG and coexisting cataracts. Copyright (c) 2012 S. Karger AG, Basel