A recent study published in the Journal of Cataract & Refractive Surgery assessed the safety and efficacy of phacoemulsification (phaco) as a first-line treatment of acute angle-closure glaucoma (AACG).
Talk about the study.
In this prospective comparative interventional case series study, 50 eyes of patients with AACG were enrolled.
After medically controlling high intraocular pressure (IOP), all participants were scheduled for phaco within 1 week of the attack.
Anything else?
Pre- and postoperative angle width was measured by anterior segment optical coherence tomography (AS-OCT) and Pentacam to evaluate angle changes.
Findings?
Following the AACG attack, the average preoperative IOP was 40.3±10.4 mmHg, which was dramatically reduced following phaco.
The mean postoperative IOP over the follow-up period was reported as:
- Week 1: 14.9±3.9 mmHg
- Week 4: 12.4±3.5 mmHg
- Week 12: 11.44±3.31 mmHg
What about the anterior chamber angle?
The average preoperative temporal angle width was 18.13°±3.65° and widened to 32.64°±4.25° in the first postoperative week.
Further widening of the temporal angle occurred at 4 and 12 weeks to 34.64°±4.37° and 36.16°±4.46°, respectively.
Go on…
Similarly, the mean preoperative nasal angle width was 17.80°±3.45, which widened postoperatively to 32.74°±4.22° at week 1, 34.50°±4.48° at week 4, and 36.18°±4.47° at week 12.
Take home.
The study authors concluded that early phacoemulsification is an effective treatment for AACG immediately after medical control of high IOP and resolution of corneal edema.
These findings demonstrate that phaco both reduces IOP and deepens the anterior chamber angle.