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Phaco, IOL implantation may be useful in angle-closure glaucoma
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COLOGNE, Germany — Primary phacoemulsification and IOL implantation is a safe and effective method for reducing intraocular pressure in patients with acute angle-closure glaucoma, according to a study.
Philipp C. Jacobi, MD, and colleagues here prospectively studied 43 eyes of 43 patients with acute angle-closure glaucoma and uncontrolled IOP. All patients had been treated with phaco. Researchers also studied an additional 32 eyes with acute angle-closure glaucoma and uncontrolled IOP that were treated with iridectomy. End points included postoperative visual acuity, IOP, number of antiglaucoma medications, complications and secondary surgical interventions required for IOP control.
Mean preoperative IOP in the phaco group was 40.5 mm Hg and 39.7 mm Hg in the control group. Mean postoperative IOP in the phaco group was 17.8 mm Hg and 20.1 mm Hg in the control group after a mean follow-up of about 10 months. Overall, glaucoma control was achieved in 31 eyes (72%) in the phaco group and in 11 eyes (35%) in the control group (P = .01).
The relative postop increase in best corrected visual acuity was 0.52 in the phaco group and 0.19 in the control group (P = .0001). Additional surgery was needed in five eyes in the phaco group and in 20 eyes in the control group. Intraoperative and postoperative complications were negligible.
The study is published in the September issue of Ophthalmology.