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CLINICAL OUTCOMES OF EARLY PHACOEMULSIFICATION IN ACUTE PRIMARY ANGLE CLOSURE
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Abstract
Introduction: Acute primary angle closure (APAC) is an ophthalmic emergency, most commonly resulting from pupillary block. Laser peripheral iridotomy (LPI) is the first-line treatment; however, it often fails to achieve sustained intraocular pressure (IOP) control and significant improvement in anterior chamber angle parameters. Phacoemulsification effectively eliminates the pupillary block and removes the lens component involved in the pathogenesis of angle closure diseases. Objective: To evaluate the changes in visual acuity (VA) and IOP following early phacoemulsification with intraocular lens implantation in APAC patients treated at the Glaucoma Department, Ho Chi Minh City Eye Hospital. Methods: A 6-month prospective longitudinal study was conducted on 34 patients with unilateral APAC. All patients underwent early phacoemulsification with posterior chamber intraocular lens implantation. Postoperative follow-ups were performed at 1, 3, and 6 months. Results: The study included 28 females and 6 males, with a mean age of 58,38 ± 7,01 years. Preoperatively, the LogMAR VA and IOP of the affected eyes were significantly worse than those of the fellow eyes (LogMAR VA: 1,24 ± 0,74 and 0,18 ± 0,13, p<0,001; IOP: 50,19 ± 8,78mmHg and 14,69 ± 2,41mmHg, p<0,001). More than 75% of the affected eyes had VA in the moderate-to-severe impairment group, according to the WHO 2015 classification. One month postoperatively, the mean LogMAR VA was 0,26 ± 0,36, which was statistically significantly lower compared to the preoperative VA (p<0,001). Thirty-two out of 34 affected eyes achieved good visual acuity, which remained stable throughout the 6-month follow-up period. The mean IOP in the affected eyes decreased by 12,82 ± 2,74mmHg mmHg at 1 month post-surgery and was statistically significantly lower than the preoperative IOP (p<0.001). The IOP remained stable within the normal range at all follow-up time points. No cases of recurrent IOP elevation were recorded during the follow-up. Conclusion: Early phacoemulsification is an effective treatment for acute primary angle closure, providing significant and sustained improvement in visual acuity and long-term intraocular pressure control.
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Keywords
Acute angle closure, cataract, early phacoemulsification, angle closure diseases.
References
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