Angle, anterior chamber parameters, and intraocular pressure changes after early phacoemulsification in acute angle-closure glaucoma

Abstract

Purpose: to evaluate the safety and efficacy of phacoemulsification as a first line treatment of acute angle closure glaucoma (AACG) and to evaluate the preoperative and postoperative anterior chamber angle width using anterior segment OCT(AS-OCT). Sittings: Sohag University Hospital, Sohag city, Egypt. Design: Prospective comparative interventional case series study Methods: Patients presented with AACG. After control of high IOP, all participants were scheduled for phacoemulsification within a week after the attack. Preoperative and postoperative angle width was measured by AS-OCT to evaluate angle changes. Results: Fifty eyes with AACG were enrolled in the study. The mean preoperative IOP was 40.3±10.4 mmHg. This acute rise of IOP was dramatically lowered to 14.9±3.9 in the first week after phacoemulsification. Further reduction of IOP continued 4 weeks and 12 weeks postoperative with values of 12.4±3.5 and 11.44±3.31. The mean preoperative temporal angle width was 18.13±3.65. In the first postoperative week the temporal angle widened to 32.64±4.25. further widening of the temporal angle occurred 4 weeks and 12 weeks postoperative to 34.64±4.37 and 36.16±4.46 respectively. The mean preoperative nasal angle width was 17.80±3.45. In the first postoperative week the nasal angle widened to 32.74±4.22. further widening of the nasal angle occurred 4 weeks and 12 weeks postoperative to 34.50±4.48 and 36.18±4.47 respectively Conclusion: Early phacoemulsification is very effective in treatment of acute angle closure glaucoma cases immediately after medical control of high IOP and resolution of corneal oedema. This was proved by imaging and measuring the angle width using