Cataract surgery in chronic appositional angle-closure glaucoma alone versus associated with angle surgery using...

To evaluate intraocular pressure (IOP) and the number of hypotensive medications in patients with mild-to-moderate appositional primary angle-closure glaucoma (PACG) after phacoemulsification surgery (phaco-only group) versus phacoemulsification combined with the implantation of two iStent® W inject trabecular stents (Glaukos Corporation, CA, USA) (phaco-iStent group).

A retrospective cohort study including 28 eyes from 28 patients with appositional PACG, divided into two groups (phaco-only and phaco-iStent). The number of medications and IOP values were recorded, at baseline, as well as, at one month, six months, and twelve months postoperatively.

Baseline and one-month postoperative mean IOP were similar in both groups (P > .05). The phaco-iStent group exhibited significantly lower IOP at six and twelve months postoperatively compared to the phaco-only group (P = .024 at six months and P = .018 at twelve months). The number of active agents was significantly lower at twelve months in the phaco-iStent group (P = ,01).

There is greater efficacy in lowering intraocular pressure over time in patients with appositional PACG if phacoemulsification is accompanied by trabecular surgery. This could be useful in patients in whom we suspect that lowering IOP with phacoemulsification alone will not be sufficient to control the disease.