comparison of efficacy of procedures in the treatment of acute angle-closure glaucoma

METHODS: Totally 60 cases of acute angle-closure glaucoma were randomly divided into 3 groups. Iris root excision or laser iridotomy was applied to group A, cataract phacoemulsification with artificial lens implantation and goniosynechialysis for group B, crabeculectomy for group C. The changes of vision, intraocular pressure, chamber angle, anterior chamber depth before and after operation were observed, while the postoperative complications and following operations were analyzed. The period of follow-up was one week, one month, three months and six months.

RESULTS: No statistical significance was found for treatments of group A and C(P>0.05). For group C the treatment was statistically significant(P<0.01). Intraocular pressure: for all three groups intraocular pressure dropped with statistical significance(P<0.05)and group C was most effective. Chamber angle change: For group B 80% chamber angles were completely open and anterior chamber depth obviously increased(P<0.01); Postoperative complications: For group A 10% to 20% cases needed medical treatments or operations. Less complication were found for group B with better improvements of vision. For group C more complications were observed with some cases of severe and enduring cases which needed re-operation.

CONCLUSION: Cataract phacoemulsification with artificial lens implantation and goniosynechialysis is a safe and effective surgery for treatment of acute angle-closure glaucoma, which can effectively improve vision, decrease intraocular pressure, open anterior chamber angle.