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Angle-closure glaucoma, or closed-angle glaucoma, is an eye condition where the iris bulges out and blocks the iridocorneal angle, resulting in a buildup of aqueous humor and increased intraocular pressure. Immediate medical attention is necessary due to the sudden onset of symptoms. The treatment for angle-closure glaucoma includes short-term and long-term approaches. Short-term treatment involves using eye drops like pilocarpine to lower intraocular pressure by increasing aqueous humor...
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In open-angle glaucoma, the iridocorneal angle remains open, but the trabecular meshwork becomes stiff, slowing down the outflow of aqueous humor. This causes a buildup of aqueous humor in the anterior chamber, leading to a sudden increase in intraocular pressure. The treatment for open-angle glaucoma focuses on reducing the elevated intraocular pressure by either decreasing the secretion of aqueous humor or increasing its outflow.
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Glaucoma is an eye condition characterized by increased intraocular pressure that damages the retina and optic nerve, leading to irreversible blindness if left untreated. The human eye has various components, including the cornea, iris, pupil, lens, and optic nerve. Aqueous humor is secreted by the epithelium of the ciliary body in the posterior chamber and flows through the trabecular meshwork and canal of Schlemm, maintaining normal intraocular pressure. The trabecular meshwork and the canal...
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Vitreous Decompression Combined with Phacoemulsification for Medically Unresponsive Acute Angle Closure.

Xiaoli Xiang1, Yuan Chen1, Jinyu Wang1

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This study shows that combining vitreous needle aspiration with phacoemulsification safely and effectively treats acute angle closure glaucoma. The procedure significantly improves vision and lowers intraocular pressure (IOP) without medication.

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Area of Science:

  • Ophthalmology
  • Glaucoma Surgery
  • Cataract Surgery

Background:

  • Acute angle closure glaucoma with shallow anterior chambers and cataracts presents complex management challenges.
  • High intraocular pressure (IOP) in these cases requires prompt and effective intervention.
  • Traditional approaches may have limitations in addressing the multifaceted nature of this condition.

Purpose of the Study:

  • To evaluate the efficacy and safety of a combined vitreous needle aspiration and phacoemulsification technique.
  • To assess the impact of this combined approach on intraocular pressure (IOP), visual acuity, and anterior chamber parameters.
  • To determine the feasibility of this technique in managing acute angle closure with concurrent cataracts and high IOP.

Main Methods:

  • A retrospective review of 17 eyes from 17 patients with acute angle closure, high IOP, and cataracts.
  • Patients underwent a combined procedure of vitreous needle aspiration followed by phacoemulsification with intraocular lens implantation.
  • Outcomes including best corrected visual acuity (BCVA), IOP, anterior chamber depth (ACD), and angle opening distance (AOD500) were analyzed.

Main Results:

  • The combined procedure was performed successfully in all cases without complications.
  • Best corrected visual acuity (BCVA) significantly improved postoperatively (p < 0.001).
  • Intraocular pressure (IOP) was significantly reduced and maintained at normal levels without medication (p < 0.001), with significant increases in ACD and AOD500 (p < 0.001).

Conclusions:

  • Vitreous needle aspiration combined with phacoemulsification is a safe and effective treatment for acute angle closure with high IOP and cataracts.
  • This technique offers significant improvements in visual function and IOP control.
  • The procedure successfully deepens the anterior chamber and opens the angles, addressing key pathophysiological aspects of angle closure glaucoma.