Anatomical effects of clear lens extraction by phacoemulsification versus trabeculectomy on anterior chamber drainage angle in primary angle-closure glaucoma (PACG) patients

Man, Xiaofei; Chan, Noel C Y; Baig, Nafees; Kwong, Yolanda Y.Y.; Leung, Dexter Yl; Li, Felix C.H.; Tham, Clement C.

doi:10.1007/s00417-015-2936-z

Cited by 44 publications

(25 citation statements)

References 19 publications

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“…The crystalline lens is larger than an IOL in anterior-posterior thickness and volume. After cataract surgery, the irislens diaphragm moves backward and increases the anterior chamber volume and expands the iridocorneal angle (8). Cataract surgery relieves the load on the anterior chamber with the removal of the swollen lens.…”

Section: Resultsmentioning

confidence: 99%

“…However, it is a subjective technique and influenced by the experience of the examiner (7). There are many studies in the literature that demonstrate the effect of phacoemulsification on narrow-angle glaucoma (8,9). The aim of this study was to evaluate these changes in open-angle glaucoma using anterior segment optical coherence tomography (AS-OCT).…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Anterior Segment Optic Coherence Tomography Changes Before and After Phacoemulsification in Primary Open Angle Glaucoma

Zırtıloğlu¹

2019

Beyoglu Eye J

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The goal of this study was to compare measurements of values such as the anterior chamber angle (ACA), thickness of the iris, thickness of the cornea, and the angle-opening distance (AOD) of eyes with primary open-angle glaucoma before and after undergoing phacoemulsification with intraocular lens implantation using anterior segment optical coherence tomography (AS-OCT). Methods: The data of 49 eyes of 39 glaucoma patients who presented at the Cataract and

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Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Anterior Segment Optic Coherence Tomography Changes Before and After Phacoemulsification in Primary Open Angle Glaucoma

Zırtıloğlu¹

2019

Beyoglu Eye J

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“…Measurement methods varied in different studies including: Haag-Streit pachymetry (Haag-Streit AG, Koeniz, Switzerland),[1316] A-scan (Cinescan; Quantel Medical, Clermont-Ferrand, France),[911] ultrasound biomicroscopy (UBM Vumax II, Sonomed Inc., NY, USA),[1719] and IOL master (Carl Zeiss Meditec AG, Jena, Germany). [18] The studies which evaluated patients in immediate postoperative periods showed that the ACD was the shallowest on days 2-4, and then deepened gradually to reach 87-91% of its preoperative values on day 14.…”

Section: Resultsmentioning

confidence: 99%

Ocular biometric changes after trabeculectomy

Alvani¹,

Pakravan²,

Esfandiari³

et al. 2016

J Ophthalmic Vis Res

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This review article aimed to evaluate ocular biometric changes after trabeculectomy. The PubMed database was searched using the keywords “axial length” (AL), “anterior chamber depth” (ACD), “corneal astigmatism,” “corneal topography” and “trabeculectomy.” The extracted studies were categorized based on the evaluated parameters and the biometry method (contact and non-contact). Comparable studies with respect to their sample size were combined for statistical analysis. Twenty-five studies including 690 individuals which met the inclusion criteria were selected. After trabeculectomy, a significant and persistent AL reduction, with a range of 0.1-0.19 and 0.1-0.9 mm measured with contact and non-contact methods, respectively, was observed. With respect to topographic changes, 0.38-1.4 diopters (D) with-the-rule (WTR) astigmatism was induced postoperatively. All studies revealed ACD reduction immediately after surgery, which gradually deepened and approximated its preoperative levels on day 14. ACD reduction was not significant after that period in the majority of cases. In conclusion, changes in ACD is of small amount and of short period, thus it can be ignored; however, reported changes in AL and keratometry are of sufficient magnitude and can affect the refractive prediction of combined cataract surgery and trabeculectomy.

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“…Asian patients have significantly lower adherence to glaucoma eyedrops than Caucasian patients, hence being medication‐free is particularly advantageous and may be associated with a better quality of life. Previous studies have shown that phacoemulsification alone is effective in lowering the IOP in angle closure eyes by widening the angle . Reduction of medication, especially in PACG patients, is also important in terms of cost‐effectiveness of treatment .…”

Section: Discussionmentioning

confidence: 99%

“…Lens extraction results in IOP reduction between 2 and 12 mmHg . The IOP‐lowering effect is greater in PACG than in POAG, through widening the angles and reducing the extent of total peripheral anterior synechiae . Previous randomized controlled trials (RCTs) have shown that combined phacoemulsification and trabeculectomy reduces the amount of glaucoma medications more than phacoemulsification alone in angle closure eyes, at the expense of a higher rate of complications …”

Section: Introductionmentioning

confidence: 99%

Phacoemulsification vs phacoemulsification with micro‐bypass stent implantation in primary angle closure and primary angle closure glaucoma: A randomized single‐masked clinical study

Chen

Sng

Sangtam

et al. 2020

Clinical Exper Ophthalmology

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Importance: Primary angle closure glaucoma (PACG) is a major cause of irreversible visual impairment in Asia, but there is no published data on the effect of iStent on these patients. Background: To compare the efficacy and safety of combined phacoemulsification and iStent implantation with standard phacoemulsification in an Asian population.Design: A prospective, single-masked, randomized study in a public tertiary eye clinic. Participants: Patients with concomitant visually significant cataracts and primary angle closure (PAC) or PACG. Methods: Patients were randomized and underwent either phacoemulsification alone (phaco) or with concurrent iStent injection (phaco-iStent). Demographic and clinical data were collected.Main Outcome Measures: Complete and qualified success rates at 12 months were compared between both treatment arms. Results: Thirty-two patients were recruited between September 2015 and February 2016. All patients completed 12 months of follow-up. There was no statistically significant difference in preoperative IOP (phaco, 17.5 ± 3.1 mmHg; phaco-iStent, 18.6 ± 4.7 mmHg, P = .65) and 12-months postoperative IOP (phaco, 15.0 ± 2.5 mmHg; phaco-iStent, 14.7 ± 3.1 mmHg, P = .86) between both groups. Complete success rates were 43.8% (95% CI, 19.8-65.6) for the Phaco group and 87.5% (95% CI, 58.6-96.7) for the Phaco-iStent group (P = .01). Thinner preoperative optical coherence tomography (retinal nerve fibre layer) thickness (hazard ratio [HR] = 7.34 [95% CI, 1.53-35.30]) and phacoemulsification alone (HR = 0.93 [95% CI, 0.87-0.02]) were independent factors associated with failure to achieve complete success.

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Anatomical effects of clear lens extraction by phacoemulsification versus trabeculectomy on anterior chamber drainage angle in primary angle-closure glaucoma (PACG) patients

Abstract: Compared to trabeculectomy, clear lens extraction resulted in a significant reduction in synechial angle closure, and an increase in anterior chamber angle width and anterior chamber depth in PACG eyes without cataract.

Cited by 44 publications

References 19 publications

Anterior Segment Optic Coherence Tomography Changes Before and After Phacoemulsification in Primary Open Angle Glaucoma

Anterior Segment Optic Coherence Tomography Changes Before and After Phacoemulsification in Primary Open Angle Glaucoma

Ocular biometric changes after trabeculectomy

Phacoemulsification vs phacoemulsification with micro‐bypass stent implantation in primary angle closure and primary angle closure glaucoma: A randomized single‐masked clinical study

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