Advantages of femtosecond laser assisted surgery in the treatment of acute angle-closure glaucoma complicated with cataract
Objective To explore the advantages of femtosecond laser-assisted surgery[phacoemulsification+goniosynechialysis(GSL)+intraocular lens(IOL)implantation]in the treatment of acute angle-closure glaucoma(AACG)complicated with cataract.Methods 60 patients with AACG complicated with cataract were divided into a control group and an observation group according to different treatment methods,with 30 cases in each group.The control group was treated with phacoemulsification+GSL+IOL implantation,and the observation group was treated with femtosecond laser-assisted phacoemulsification+GSL+IOL implantation.The intraocular pressure,corrected visual acuity,central anterior chamber depth,peripheral anterior chamber depth,anterior chamber angle,ocular axis,corneal endothelial cell count and central corneal thickness were compared between the two groups.Results(i)Before treatment,the intraocular pressure and corrected visual acuity were(18.6±2.3)mm Hg(1 mm Hg=0.133 kPa)and(0.33±0.19)in the observation group,and(19.2±1.9)mm Hg and(0.36±0.17)in the control group.After treatment,the intraocular pressure and corrected visual acuity were(10.7±4.2)mm Hg and(0.65±0.26)in the observation group,and(12.1±4.6)mm Hg and(0.41±0.18)in the control group.Before treatment,there was no difference in the comparison of intraocular pressure and corrected visual acuity between the two groups(P>0.05).After treatment,there was no difference in the comparison of intraocular pressure between the two groups(P>0.05).The corrected visual acuity of the observation group was higher than that of the control group after treatment(P<0.05).(ii)Before treatment,the central anterior chamber depth and peripheral anterior chamber depth were(2.56±0.28)and(0.80±0.18)mm in the observation group,and(2.57±0.24)and(0.73±0.15)mm in the control group.After treatment,the central anterior chamber depth and peripheral anterior chamber depth were(3.70±0.22)and(0.88±0.10)mm in the observation group,and(3.64±0.27)and(0.83±0.12)mm in the control group.Before treatment,there was no difference in central anterior chamber depth and peripheral anterior chamber depth between the two groups(P>0.05).After treatment,the central anterior chamber depth and peripheral anterior chamber depth increased significantly in both groups(P<0.05),but there was no difference between the two groups(P>0.05).(iii)Before treatment,the anterior chamber angle and ocular axis were(11.02±8.22)° and(21.78±0.51)mm in the observation group,and(12.10±7.59)°and(21.55±0.49)mm in the control group.After treatment,the anterior chamber angle and ocular axis were(27.10±7.68)° and(20.63±0.70)mm in the observation group,and(25.10±7.59)° and(20.62±0.68)mm in the control group.Before treatment,there was no difference between the two groups in anterior chamber angle and ocular axis(P>0.05).After treatment,the anterior chamber angle was obviously enlarged and the ocular axis was obviously shortened in both groups(P<0.05),but there was no difference between the two groups(P>0.05).(iv)Before treatment,the corneal endothelial cell count and central corneal thickness were(2413.13±347.24)/mm2 and(514.41±52.21)μm in the observation group,and(2414.00±348.36)/mm2 and(536.51±53.24)μm in the control group.After treatment,the corneal endothelial cell count and central corneal thickness were(2382.54±423.11)/mm2 and(537.09±42.34)μm in the observation group,and(1941.00±254.14)/mm2 and(539.66±41.82)μm in the control group.Before treatment,there were no differences in corneal endothelial cell count and central corneal thickness between the two groups(P>0.05).After treatment,the corneal endothelial cell count in the observation group was higher than that in the control group(P<0.05).There was no difference in the central corneal thickness between the two groups after treatment(P>0.05).Conclusion In the case of AACG with cataract,femtosecond laser-assisted phacoemulsification+GSL+IOL implantation can not only open the anterior chamber angle,relieve the pupillary block,and effectively reduce the intraocular pressure,but also has the advantages of light postoperative anterior segment reaction,less loss of corneal endothelial cells,and good IOL centration.It is a safe and effective surgical method,and is worthy of promotion.
Acute angle-closure glaucomaFemtosecond laserGoniosynechialysisPhacoemulsificationCataractCorneal endothelial cell loss
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