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Phaco widens anterior chamber angle in eyes with PACG

Eur J Ophthalmol. 2011;21(5):559-565

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Phacoemulsification and foldable IOL implantation caused a widening of the anterior chamber angle in eyes with primary angle-closure glaucoma, leading to improved postop IOP control, a study found.

The prospective, interventional study included 46 eyes of 46 patients with chronic primary angle-closure glaucoma and cataract who underwent patent laser iridotomy. The primary outcome measures were IOP, central anterior chamber depth, trabecular iris angle and angle opening distance at 250 µm and 500 µm from the scleral spur. Mean patient age was 56.5 years.

Mean preoperative IOP was 25 mm Hg on maximum anti-glaucoma medication. Mean IOP decreased to 15.8 mm Hg at 3 months after surgery (P = .0001). After phacoemulsification, the trabecular iris angle widened significantly (P < .001), and the angle opening distance at both 250 µm and 500 µm as well as central anterior chamber depth showed statistically significant increases (P < .001).

"These finding are of clinical significance in obviating the need for simultaneous filtering surgery in eyes with PACG undergoing phacoemulsification cataract surgery," the study authors said.