Clinical Ophthalmology (Apr 2023)

Three-Year Outcomes of Immediate Primary Phacoemulsification on Acute Primary Angle Closure Eyes and the Fellow Eyes

  • Suzuki T,
  • Fujishiro T,
  • Tachi N,
  • Ueta Y,
  • Okamoto Y,
  • Fukutome T,
  • Sasajima H,
  • Ishida H,
  • Watanabe Y,
  • Hashimoto Y

Journal volume & issue
Vol. Volume 17
pp. 1035 – 1045

Abstract

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Takafumi Suzuki,1,2 Takashi Fujishiro,2 Naoko Tachi,1,3 Yoshiki Ueta,1 Yasuhiro Okamoto,1 Takao Fukutome,1 Hirofumi Sasajima,1 Hidetoshi Ishida,1,4 Yuji Watanabe,1 Yoshihiro Hashimoto1 1Department of Ophthalmology, Shinseikai Toyama Hospital, Imizu, Japan; 2Department of Ophthalmology, The University of Tokyo Hospital, Bunkyo, Japan; 3Tachi Eye Clinic, Toyama, Japan; 4Department of Ophthalmology, Kanazawa Medical University, Ishikawa, JapanCorrespondence: Takashi Fujishiro, Department of Ophthalmology, University of Tokyo Graduate School of Medicine, 7-3-1 Hongō, Bunkyō-ku, Tokyo, 113-8655, Japan, Tel +81-3-3815-5411, Email [email protected]: This study investigated the long-term outcomes (> 3 years) of immediate primary phacoemulsification in eyes with acute primary angle closure (APAC) and in the fellow eyes with shallow anterior chamber to prevent APAC development.Patients and Methods: This is a retrospective study of phacoemulsification for APAC using bilateral eyes. Best-corrected visual acuity (BCVA), intraocular pressure (IOP), and number of IOP-lowering medications at the preoperative examination (Pre), postoperative month 1 (1m), year 3 (3y), and last visit were compared between 14 eyes with APAC and their 14 fellow eyes. The number of corneal endothelial cells (CECs) at Pre and at more than 2 weeks after phacoemulsification was compared. The visual field mean deviation (MD) within 1 year after phacoemulsification and at the last visit was also compared.Results: For APAC eyes, BCVA was significantly improved at 1m, 3y, and at the last visit as compared with Pre (p < 0.05). IOP significantly decreased at 1m, 3y, and at the last visit compared with Pre (p < 0.05). IOP-lowering medication use decreased significantly from Pre to 1m (p < 0.05). The number of CECs was not significantly different between Pre and more than 2 weeks after phacoemulsification. BCVA was significantly worse in APAC eyes than in fellow eyes at Pre (p < 0.05). IOP and the number of IOP-lowering medications were significantly higher in APAC eyes than in fellow eyes at Pre (p < 0.05).Conclusion: Primary phacoemulsification improved visual acuity for APAC eyes and maintained good IOP control without the need for reoperation. Moreover, it preserved the number of CECs for the APAC and fellow eyes in the long term.Keywords: acute primary angle closure, fellow eye, long-term outcome, phacoemulsification

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