Changes in Choroidal Thickness and Its Effects on the Refractive Outcome After Surgical Treatment of Cataract Using Phacoemulsification Combined With Goniosynechialysis in Patients With Primary Angle Closure/Glaucoma.

PURPOSE: To evaluate changes in choroidal thickness (CT) and their association with refractive outcomes after phacoemulsification combined with goniosynechialysis (Phaco-GSL) in patients with primary angle-closure/glaucoma (PAC/PACG).

METHODS

This study involved 79 eyes from 54 patients with PAC/PACG who underwent Phaco-GSL. Intraocular pressure (IOP), best-corrected visual acuity (BCVA), and CT were measured preoperatively and at 1 week (W1), 1 month (M1), 3 months (M3), and 6 months (M6) postoperatively. In addition, anterior chamber depth (ACD), axial length (AL), visual field mean deviation (MD), and mean refractive error (MRE) were recorded preoperatively and at the final follow-up visit. Correlations between ocular biometric parameters and MRE were analyzed using appropriate statistical methods.

RESULTS

Within 6 months after Phaco-GSL, CT measured at 13 predefined locations showed an initial postoperative increase, followed by a gradual decline, eventually returning to baseline levels. IOP decreased at W1 and stabilized at M6. In addition, subfoveal choroidal thickness (SFCT) was negatively correlated with IOP preoperatively (p < 0.05) and AL both preoperatively and at M6 (p < 0.01) but positively related to MD at M6. Moreover, CT changes were positively correlated with MRE (p < 0.05), while changes in ACD, AL, and IOP were not associated with MRE (all, p > 0.05).

CONCLUSION

These findings suggest that CT initially increases and then decreases over a 6-month period following Phaco-GSL. CT is associated with IOP, AL, and MD reductions. Furthermore, CT changes are associated with an increase in MRE, offering valuable insights into the refractive shifts in PAC/PACG patients after Phaco-GSL.