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Early Phacoemulsification After Acute Angle Closure in Patients With Coexisting Cataract
Hellen C S Römkens1, Henny J M Beckers1, Jan S A G Schouten2
1University Eye Clinic Maastricht, Maastricht University Medical Center+, Maastricht.
Journal of Glaucoma
|July 14, 2018
Summary
Early cataract surgery (phacoemulsification) effectively manages acute angle closure glaucoma in patients with cataracts. This procedure reduces eye pressure and medication needs, improving vision.
Area of Science:
- Ophthalmology
- Glaucoma Management
- Cataract Surgery
Background:
- Acute angle closure glaucoma (AACG) poses a significant threat to vision.
- Cataracts can exacerbate AACG, complicating management.
- Standard initial treatment involves medical therapy and laser peripheral iridotomy.
Purpose of the Study:
- To evaluate the efficacy of early phacoemulsification in managing AACG with coexisting cataracts.
- To assess the impact of early surgery on intraocular pressure (IOP), medication use, and visual acuity.
Main Methods:
- Retrospective analysis of 35 patients with AACG and cataracts treated between 2005-2015.
- Patients received initial medical and laser treatment before undergoing phacoemulsification with intraocular lens implantation within 3 months.
- Outcomes measured included IOP, glaucoma medication count, visual acuity, and complications.
Main Results:
- Phacoemulsification led to a significant decrease in IOP (17.0 to 13.2 mmHg, P=0.008).
- The mean number of glaucoma medications dropped significantly (2.9 to 0.7, P<0.001), with 56% discontinuing all medications.
- Visual acuity improved markedly (0.9 to 0.2 logMAR, P<0.001) with no reported complications.
Conclusions:
- Early phacoemulsification is a safe and effective treatment for AACG in patients with cataracts.
- The procedure significantly reduces IOP and medication dependence.
- Improved visual acuity and a favorable safety profile make early surgery a promising option.
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