Background: To investigate the long-term visual field (VF) outcome and baseline factors associated with functional sequelae in patients who experienced an episode of acute primary angle closure (APAC) and underwent subsequent lens extraction. Methods: Fifty patients (50 eyes) who experienced an APAC episode and underwent subsequent lens extraction at Chonnam National University Hospital were enrolled in this retrospective study. Patients underwent VF examinations after 1 year of an acute episode. They were classified into two groups based on whether they had significant VF defects or not. Demographic data were recorded, and baseline anterior-segment OCT (AS-OCT) images were analysed. Multivariate logistic regression analysis was performed to assess baseline risk factors for presence of VF defects.Results: Twenty-five (50%) eyes were found to have varied degree of VF defects after 1 year of an acute episode. Longer duration between the symptom onset and IOP lowering (p = 0.005), a higher presenting IOP (p = 0.014), and flat iris curvature (p = 0.037) at baseline AS-OCT measurement were significant predictors of VF loss. The area under the receiver operating characteristic curve (AUC) revealed that combination of these three potential baseline factors could predict the long-term VF outcome (AUC = 0.921).Conclusions: Patients exhibiting a long duration between symptom onset and IOP lowering, a high presenting IOP, and flat iris curvature were at a higher risk of visual impairment after an episode of APAC. The eyes with such features may require more careful follow-up after an episode of APAC.

Background: To investigate long-term outcomes of prediction error after phacotrabeculectomy and to determine risk factors that may cause unstable prediction error after phacotrabeculectomy in glaucoma patients.Methods: A total 120 eyes of 120 patients who had underwent uncomplicated phacotrabeculectomy (combined group) or phacoemulsification (phaco-only group) were included. Best-corrected visual acuity (BCVA), intraocular pressure (IOP) were measured before and after surgery, and anterior segment parameters including anterior chamber depth (ACD), lens vault (LV), and anterior vault (AV) measured using anterior-segment optical coherence tomography were compared between the two groups. The mean absolute error (MAE) at 3, 6, 12, and 24 months postoperatively were compared. Risk factors associated with unstable prediction error (MAE ≥ 0.5) were investigated in the combined group.Results: In both groups, BCVA was improved and IOP was decreased significantly. MAE at 3, 6, 12, 24 months postoperatively were not significantly different between two groups. The risk factors for unstable prediction error after 12 months of phacotrabeculectomy were old age and LV. Whereas, the only factor predicting unstable prediction error after 24 months of phacotrabeculectomy was LV. The cut-off value of LV for predicting unstable refractive error analyzed by the ROC curve was 0.855 mm.Conclusions: Phacotrabeculectomy may be an effective treatment with stable long-term outcomes of prediction error similar to phacoemulsification in patients with glaucoma. However, elderly patients or patients with large LV may be predisposed to unstable prediction error after phacotrabeculectomy.

Background: To investigate long-term outcomes of prediction error after phacotrabeculectomy and to determine risk factors that may cause unstable prediction error after phacotrabeculectomy in glaucoma patients. Methods: A total 120 eyes of 120 patients who had underwent uncomplicated phacotrabeculectomy (combined group) or phacoemulsification (phaco-only group) were included. Best-corrected visual acuity (BCVA), intraocular pressure (IOP) were measured before and after surgery, and anterior segment parameters including anterior chamber depth (ACD), lens vault (LV), and anterior vault (AV) measured using anterior-segment optical coherence tomography were compared between the two groups. The mean absolute error (MAE) at 3, 6, 12, and 24 months postoperatively were compared. Risk factors associated with unstable prediction error (MAE ≥ 0.5) were investigated in the combined group. Results: In both groups, BCVA was improved and IOP was decreased significantly. MAE at 3, 6, 12, 24 months postoperatively were not significantly different between two groups. The risk factors for unstable prediction error after 12 months of phacotrabeculectomy were old age and LV. Whereas, the only factor predicting unstable prediction error after 24 months of phacotrabeculectomy was LV. The cut-off value of LV for predicting unstable refractive error analyzed by the ROC curve was 0.855 mm. Conclusions: Phacotrabeculectomy may be an effective treatment with stable long-term outcomes of prediction error similar to phacoemulsification in patients with glaucoma. However, elderly patients or patients with large LV may be predisposed to unstable prediction error after phacotrabeculectomy.