Angle parameter changes of phacoemulsification and combined phacotrabeculectomy for acute primary angle closure

Area of Science:

• Ophthalmology
• Surgical Innovation
• Anterior Segment Surgery

Background:

• Acute primary angle closure (APAC) is a critical condition requiring prompt intervention.
• Understanding the comparative efficacy of different surgical approaches is vital for patient outcomes.
• Ultrasound biomicroscopy (UBM) provides detailed anterior segment imaging.

Purpose of the Study:

• To compare angle parameters and clinical outcomes of phacoemulsification versus combined phacotrabeculectomy in APAC patients.
• To assess the efficacy of each surgical technique using ultrasound biomicroscopy (UBM).

Main Methods:

• Randomized controlled trial involving 23 patients (31 eyes) undergoing phacoemulsification and 24 patients (31 eyes) undergoing combined phacotrabeculectomy.
• Preoperative and postoperative assessment of best-corrected visual acuity (BCVA), intraocular pressure (IOP), and angle parameters via UBM and gonioscopy.
• Documentation of surgical complications.

Main Results:

• Phacoemulsification group demonstrated significantly greater improvement in BCVA (P<0.05).
• Intraocular pressure (IOP) control was comparable between groups at later follow-up points.
• Phacoemulsification alone led to a slight increase in trabecular-ciliary process distance (P<0.05), with fewer complications compared to combined surgery.

Conclusions:

• Both phacoemulsification and combined phacotrabeculectomy effectively open the drainage angle and deepen the anterior chamber in APAC.
• Phacoemulsification monotherapy shows superior visual function improvement and a lower complication rate.
• Surgical choice should consider the balance between IOP control, visual recovery, and surgical risk.