Retrospective analysis of surgical treatment of closed-angle glaucoma with persistent high intraocular pressure

Abstract

AIM:To observe the safety and clinical curative effect of trabeculectomy on continuous high intraocular pressure(IOP)in primary angle-closure glaucoma. METHODS:From January 2013 to January 2015, 45 patients(46 eyes)with high IOP in primary angle-closure glaucoma were treated in the department of ophthalmology in our hospital. The age of patients was(56.9±9.4)years old, ranged from 43～81 years. All the patients underwent the examinations of visual acuity, best corrected visual acuity(BCVA), slit lamp, fundus IOP, perimetry and ultrasound B scan. Under local anesthesia, the patients underwent anterior chamber paracentesis, postoperative they received topical acetate prednisolone eye drops and tobramycin and dexamethasone eye ointment, combining with IOP lowering eye drops and glycerol fructose injection intravenous to further control IOP. Two days after surgery, the patients received trabeculectomy with amniotic membrane implantation and intracameral gas injection(some cases underwent pars plana puncture). Visual acuity, BCVA, IOP, slit lamp, fundus were observed postoperative and complications occurred during the operation were recorded.RESULTS:The average IOP at 1 and 2d after anterior chamber puncture were 21.4±5.2, 20.3±4.8mmHg(1kPa=7.5mmHg), which was significantly lower than that before surgery(F=492.601, PF=857.508, Pt=10.191, 10.950, 9.523, PPCONCLUSION:For acute primary angle closure glaucoma with persistent high IOP, anterior chamber puncture and intracameral gas injection combined with trabeculectomy is a safe and effective method, which can reduce intraoperative and postoperative complications and improve the visual acuity of most patients.

Keywords

• persistent high intraocular pressure
• anterior chamber paracentesis
• intracameral air injection