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Impressum
Primary phacoemulsification and intraocular lens implantation for acute angle-closure glaucoma
Jacobi P. C., Dietlein T. S., Lüke C., Engels B., Krieglstein G. K.
University of Cologne, Department of Ophthalmology, Joseph- Stelzmannstr. 9, 50931 Cologne, Germany
Objective: To evaluate the safety and efficacy of primary phacoemulsification
and intraocular lens implantation (PPI) for acute angleclosure glaucoma
(ACG) in a prospective, nonrandomized comparative trial.
Participants and Intervention: Forty-three eyes of 43 patients
presented with acute ACG and uncontrolled intraocular pressure (IOP) and
were treated by PPI. Thirty-two eyes of 32 patients treated by conventional
surgical iridectomy (CSI) constituted the control group.
Results: Glaucoma control was achieved in 31 eyes (72%) in the
PPI group and in 11 (35%) in the CSI group (P=0.01). Mean preoperative
IOP was 40.5±7.6 mmHg (SD) and 39.7±7.8 mmHg, respectively
(P=0.46). Mean postoperative IOP was 17.8±3.4 mmHg (PPI
group) and 20.1±4.2 mmHg (CSI group) after a mean follow-up of
10.2±3.4 months (P=0.03). Post-operatively, mean number
of ocular hypotensive medications was 0.18±0.45 (PPI group) and
0.45±0.62 (CSI group) (P=0.0001). Relative increase in postoperative
best-corrected visual acuity (logMAR) was 0.52±0.29 (PPI group)
and 0.19±0.21 (CSI group), respectively (0.0001). Additional surgery
was held necessary in 5 eyes (11.5%) in the PPI group and in 20 eyes (63%)
in the CSI group (P=0.01).
Conclusion: The present results affirm that lens extraction may
be considered the better procedure in uncontrolled angle-closure glaucoma
when faced with options of CSI of PPI.