Long-Term Effect of Early Phacoemulsification in Primary Angle Closure Glaucoma Patients with Cataract: A 10-Year Follow-Up Study

Hazem Helmy Glaucoma and Optic Nerve Disease Department, Research Institute of Ophthalmology, Giza, EgyptCorrespondence: Hazem HelmyGlaucoma and Optic Nerve Disease Department, Research Institute of Ophthalmology, 2 El Ahram Street, Giza, 12577, EgyptTel +201224004991; +2022315228Email hazem.helmy@y...

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Auteur principal:	Helmy H
Format:	article
Langue:	EN
Publié:	Dove Medical Press 2021
Sujets:	primary angle closure glaucoma early phacoemulsification anterior chamber depth angle width ubm. Ophthalmology RE1-994
Accès en ligne:	https://doaj.org/article/24d4f9a561da41cdb4a5de35251b6739
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spelling	oai:doaj.org-article:24d4f9a561da41cdb4a5de35251b67392021-12-02T19:16:13ZLong-Term Effect of Early Phacoemulsification in Primary Angle Closure Glaucoma Patients with Cataract: A 10-Year Follow-Up Study1177-5483https://doaj.org/article/24d4f9a561da41cdb4a5de35251b67392021-09-01T00:00:00Zhttps://www.dovepress.com/long-term-effect-of-early-phacoemulsification-in-primary-angle-closure-peer-reviewed-fulltext-article-OPTHhttps://doaj.org/toc/1177-5483Hazem Helmy Glaucoma and Optic Nerve Disease Department, Research Institute of Ophthalmology, Giza, EgyptCorrespondence: Hazem HelmyGlaucoma and Optic Nerve Disease Department, Research Institute of Ophthalmology, 2 El Ahram Street, Giza, 12577, EgyptTel +201224004991; +2022315228Email hazem.helmy@yahoo.comPurpose: To assess the 10-year effects of early phacoemulsification with intraocular lens (IOL) implantation in primary angle closure glaucoma (PACG) patients with cataract.Patients and Methods: This prospective cohort study included 102 eyes of 102 patients with PACG. All patients had coexisting cataracts compromising vision. Patients underwent phacoemulsification and foldable IOL implantation. The main outcome measures were anterior chamber depth (ACD), angle width, value of intraocular pressure (IOP), and number of medications needed postoperatively and during follow-up.Results: Half (53%) of the patients were female, with ages ranging from 55 to 73 with a mean of 59.82± 5.19 years. Mean IOP decreased significantly from 22.15± 2.08 mmHg at baseline to 14.08± 2.13 mmHg postoperatively (p˂ 0.05). The ACD increased from 2.2± 0.21 preoperatively to 3.73± 0.25 postoperatively (p˂0.001). Nasal angle width increased postoperatively to 40.05± 2.09 compared to the preoperative value of 16.02± 2.08 (p˂0.001). Temporal angle width increased from 13.05± 2.07 to 41.9600± 1.94 (p˂0.001). Anti-glaucoma treatment significantly decreased postoperatively (p˂0.001). A significant positive correlation was detected between ACD and angle width, while a negative correlation was detected between IOP and both ACD and angle width (p˂0.001). There was also a significant negative correlation between postoperative angle width and IOP (p˂0.001). Preoperative lens thickness was positively correlated with preoperative IOP and number of medications, while it was negatively correlated with preoperative AC depth and angle width. Preoperative lens thickness positively correlated with postoperative IOP and medications. Complete and qualified success was achieved in 69.65% and 30.4% of cases, respectively, while 2.9% failed to be controlled. Visual acuity significantly improved from 0.17± 0.1 to 0.9± 0.08 (p˂0.001). All parameters showed high stability throughout the follow-up period.Conclusion: Phacoemulsification with IOL implantation is a safe and effective early modality for long-term control of IOP in PACG patients with coexisting cataract. The effects can persist for at least 10 years.Keywords: primary angle closure glaucoma, early phacoemulsification, anterior chamber depth, angle width, UBMHelmy HDove Medical Pressarticleprimary angle closure glaucomaearly phacoemulsificationanterior chamber depthangle widthubm.OphthalmologyRE1-994ENClinical Ophthalmology, Vol Volume 15, Pp 3969-3981 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	primary angle closure glaucoma early phacoemulsification anterior chamber depth angle width ubm. Ophthalmology RE1-994
spellingShingle	primary angle closure glaucoma early phacoemulsification anterior chamber depth angle width ubm. Ophthalmology RE1-994 Helmy H Long-Term Effect of Early Phacoemulsification in Primary Angle Closure Glaucoma Patients with Cataract: A 10-Year Follow-Up Study
description	Hazem Helmy Glaucoma and Optic Nerve Disease Department, Research Institute of Ophthalmology, Giza, EgyptCorrespondence: Hazem HelmyGlaucoma and Optic Nerve Disease Department, Research Institute of Ophthalmology, 2 El Ahram Street, Giza, 12577, EgyptTel +201224004991; +2022315228Email hazem.helmy@yahoo.comPurpose: To assess the 10-year effects of early phacoemulsification with intraocular lens (IOL) implantation in primary angle closure glaucoma (PACG) patients with cataract.Patients and Methods: This prospective cohort study included 102 eyes of 102 patients with PACG. All patients had coexisting cataracts compromising vision. Patients underwent phacoemulsification and foldable IOL implantation. The main outcome measures were anterior chamber depth (ACD), angle width, value of intraocular pressure (IOP), and number of medications needed postoperatively and during follow-up.Results: Half (53%) of the patients were female, with ages ranging from 55 to 73 with a mean of 59.82± 5.19 years. Mean IOP decreased significantly from 22.15± 2.08 mmHg at baseline to 14.08± 2.13 mmHg postoperatively (p˂ 0.05). The ACD increased from 2.2± 0.21 preoperatively to 3.73± 0.25 postoperatively (p˂0.001). Nasal angle width increased postoperatively to 40.05± 2.09 compared to the preoperative value of 16.02± 2.08 (p˂0.001). Temporal angle width increased from 13.05± 2.07 to 41.9600± 1.94 (p˂0.001). Anti-glaucoma treatment significantly decreased postoperatively (p˂0.001). A significant positive correlation was detected between ACD and angle width, while a negative correlation was detected between IOP and both ACD and angle width (p˂0.001). There was also a significant negative correlation between postoperative angle width and IOP (p˂0.001). Preoperative lens thickness was positively correlated with preoperative IOP and number of medications, while it was negatively correlated with preoperative AC depth and angle width. Preoperative lens thickness positively correlated with postoperative IOP and medications. Complete and qualified success was achieved in 69.65% and 30.4% of cases, respectively, while 2.9% failed to be controlled. Visual acuity significantly improved from 0.17± 0.1 to 0.9± 0.08 (p˂0.001). All parameters showed high stability throughout the follow-up period.Conclusion: Phacoemulsification with IOL implantation is a safe and effective early modality for long-term control of IOP in PACG patients with coexisting cataract. The effects can persist for at least 10 years.Keywords: primary angle closure glaucoma, early phacoemulsification, anterior chamber depth, angle width, UBM
format	article
author	Helmy H
author_facet	Helmy H
author_sort	Helmy H
title	Long-Term Effect of Early Phacoemulsification in Primary Angle Closure Glaucoma Patients with Cataract: A 10-Year Follow-Up Study
title_short	Long-Term Effect of Early Phacoemulsification in Primary Angle Closure Glaucoma Patients with Cataract: A 10-Year Follow-Up Study
title_full	Long-Term Effect of Early Phacoemulsification in Primary Angle Closure Glaucoma Patients with Cataract: A 10-Year Follow-Up Study
title_fullStr	Long-Term Effect of Early Phacoemulsification in Primary Angle Closure Glaucoma Patients with Cataract: A 10-Year Follow-Up Study
title_full_unstemmed	Long-Term Effect of Early Phacoemulsification in Primary Angle Closure Glaucoma Patients with Cataract: A 10-Year Follow-Up Study
title_sort	long-term effect of early phacoemulsification in primary angle closure glaucoma patients with cataract: a 10-year follow-up study
publisher	Dove Medical Press
publishDate	2021
url	https://doaj.org/article/24d4f9a561da41cdb4a5de35251b6739
work_keys_str_mv	AT helmyh longtermeffectofearlyphacoemulsificationinprimaryangleclosureglaucomapatientswithcataracta10yearfollowupstudy
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Long-Term Effect of Early Phacoemulsification in Primary Angle Closure Glaucoma Patients with Cataract: A 10-Year Follow-Up Study

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