Phacoemulsification treatment of subjects with acute primary angle closure and chronic primary angle-closure glaucoma.

PURPOSE: To investigate and compare the effects of phacoemulsification as an initial procedure to control intraocular pressure (IOP) in eyes with acute primary angle closure (APAC) and chronic primary angle-closure glaucoma (CPACG) with coexisting cataracts and peripheral anterior synechiae (PAS) of greater than 180 degrees.

SETTING

Prospective, cross-sectional study.

METHODS

Thirteen patients (13 eyes) with APAC and 10 patients (10 eyes) with CPACG were enrolled in the study. IOP control in the 2 groups was compared at final follow-up. Other outcome measures included visual acuity, anterior chamber depth, gonioscopic appearance, and complications.

RESULTS

The postoperative IOP was reduced in both the APAC and CPACG groups. As assessed at last follow-up (median 6 mo), IOP in the APAC group was significantly lower than that in the CPACG group. The absolute success rate was 100% in the APAC group and 80% in the CPACG group. The number of hypotensive medications decreased in both APAC and CPACG group. The postoperative degree of PAS was relieved in 11 of 12 eyes with APAC and 5 of 9 eyes with CPACG.

CONCLUSIONS

Initial phacoemulsification performed to provide short-term control of IOP is more efficacious in patients with APAC than in those with CPACG, especially when PAS is greater than 180 degrees.