Effectiveness of Phacoemulsification Combined with Goniosynechialysis in the Treatment of Angle-Closure Glaucoma with Cataract and its Impact on Anterior Chamber Angle Structures
Objective:To explore the effectiveness and impact on the angle structure of the combination of phacoemulsification and goniosynechialysis in the treatment of angle-closure glaucoma with concurrent cataract.Methods:Selecting 62 cases of closed-angle glaucoma treated in the Ophthalmology Department of Kunshan Traditional Chinese Medicine Hospital in Jiangsu Province from January 2018 to January 2023 as the research sample.They were divided into two groups according to different treatment plans:the control group(n=31,receiving trabeculectomy+phacoemulsification),and the study group(n=31,receiving iridotomy+cataract phacoemulsification).The patients were observed for three months.The clinical effectiveness,preoperative and postoperative intraocular pressure(IOP),astigmatism,best corrected visual acuity,and anterior chamber angle structure(central anterior chamber depth,trabecular-iris angle,angle opening distance,and trabecular ciliary process distance),angle opening status,and complication rates were compared between the groups.Results:The clinical treatment effectiveness was higher in the study group than in the control group(x2=6.269,P＜0.05).Three months after operation,diffuser of the study group was lower than the control group,and the difference was statistically significant(t=8.266,P＜0.05).1 month after surgery,the central anterior chamber depth,trabecular iris angle,and opening distance of chamber angle in the study group were higher than those in the control group,with statistically significant difference(t=2.767,6.885,3.819;P＜0.05).1 month and 3 months after surgery,narrow chamber Angle grades Ⅲ～Ⅳ decreased to Ⅰ～n in 2 groups,and the wide chamber angle opening in the study group was higher than that in the control group.The difference was statistically significant(x2=6.941,8.098;P＜0.05).The complication rate of the observation group was lower than that of the control group,and the difference was statistically significant(x2=5.833,P＜0.05).Conclusion:Phacoemulsification combined with goniosynechialysis has shown safety and effectiveness in the treatment of angle-closure glaucoma with concurrent cataract.It can significantly improve astigmatism and anterior chamber angle structures,and reduce the risk of complications.
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