impact of phacoemulsification surgery on intraocular pressure in primary angle-closure glaucoma

Pur po se: To investigate whether primary phacoemulsification in acute primary angle closure glaucoma (APACG) and chronic primary angle closure glaucoma (CPACG) will lower intraocular pressure (IOP) or not. Ma te ri al and Met hod: This retrospective, non-comparative, consecutive, interventional case series includes 22 eyes of 20 patients with APACG and 31 eyes of 23 patients with CPACG. All eyes had undergone phacoemulsification surgery without any reference to the presence of cataract. Data about IOP, number of antiglaucoma medications and best corrected visual acuity (BCVA) were collected. Re sults: In APACG mean IOP (95% CI), number of antiglaucoma medications and Snellen visual acuity changed at last preoperative evaluation from 30.9±15.6 mmHg (23.0-38.0), 2.6±1.4 boxes and 0.4±0.2 lines to 15.5±3.9 mm Hg (p<0.000, 13.8-17.0), 0.6±0.9 boxes (p<0.000) and 0.6±0.3 lines (p=0.001) at last follow-up. Same parameters in CPACG changed from 18.0±7.8 mmHg (15.1- 20.8), 1.6±1.1 boxes and 0.5±0.2 lines at last preoperative evaluation to 14.7±3.6 mmHg (p<0.023, 13.4-16.0), 0.5±0.8 boxes (p<0.000) and 0.6±0.3 lines (p=0.007) at last follow-up. Mean follow-up (95% CI) for APACG and CPACG were 554±646 (268-841) and 747±820 (438-1041) days respectively. In APACG and CPACG groups 19 eyes (86%) and 16 eyes (52%) had lower IOP respectively at last follow-up. 59% of the eyes with APACG and 61% of the eyes with CPACG were classified as complete success when it was defined as IOP ≤18mmHg without any antiglaucoma medications. Dis cus si on: Primary phacoemulsification without any reference to cataract is a safe and effective procedure in terms of IOP control and reducing the number of antiglaucoma drops in APACG and CPACG. (Turk J Ophthalmol 2012; 42: 438-42)