J Korean Ophthalmol Soc.  2016 Jul;57(7):1126-1133. 10.3341/jkos.2016.57.7.1126.

Clinical Outcomes of Early Phacoemulsification after Laser Iridotomy in Acute Angle-closure Glaucoma

• Baek SU
• Choi DC
• Lee KW

• KMID: 2317574
• DOI: http://doi.org/10.3341/jkos.2016.57.7.1126

Abstract

PURPOSE
To evaluate long-term change in intraocular pressure (IOP) in eyes undergoing laser iridotomy (LI) and early phacoemulsification after LI in patients with acute angle-closure glaucoma (AACG).
METHODS
The retrospective, comparative chart review included patients with AACG, Group A who underwent only LI and Group B who underwent early phacoemulsification within 1 month after LI. Patients were followed up on day 1; week 1; and months 1, 3, 6, and 12 after LI. IOP changes were studied.
RESULTS
This study included a total 99 eyes from 99 patients, 37 in group A and 62 in group B. The mean IOP were not significantly different between the two groups at the initial visit or 1 month later. However, group B showed a consistently lower mean IOP that that of group A at 3, 6, and 12 months (p= 0.003, <0.001, <0.001, respectively). The prevalence of IOP increase to greater than 21 mmHg was 3 (8.11%), 5 (13.51%), and 5 patients (13.51%) in group A and 0, 2 (5.41%), and 1 patients (1.61%) in group B at 3, 6, and 12 months, respectively. Group B showed a significantly lower prevalence of IOP increase (p = 0.050, 0.038, 0.026).
CONCLUSIONS
We found that patients treated with early phacoemulsification after LI had better outcomes of well-maintained IOP compared to those undergoing LI alone. For AACG patients with coexisting cataract, early phacoemulsification after LI can be considered as a reasonable treatment to maintain IOP.

Keyword

Acute angle-closure glaucoma; Laser iridotomy; Phacoemulsification

MeSH Terms

Cataract
Glaucoma, Angle-Closure*
Humans
Intraocular Pressure
Phacoemulsification*
Prevalence
Retrospective Studies

Figure

• 

  Figure 1. Change of mean intraocular pressure for the Group A and B. Group A was 37 patients who underwent only laser iridotomy (LI) and Group B was 62 patients who underwent early phacoemulsification after LI within 1 month. The mean intraocular pressure (IOP) between two groups were not significantly different at initial visit and 1 month. But group B showed consistently lower mean IOP that that of group A for the follow-up at 3, 6, 12 months (p = 0.003, <0.001, <0.001). * p < 0.05 by independent samples t-test.

Reference

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