Comparison of phacoemulsification combined with goniosynechialysis and trabeculectomy in the treatment of APACG

Abstract

AIM: To evaluate and compare the quality of life of patients submitted to phacoemulsification combined with goniosynechialysis(PPI+GSL)and trabeculectomy, and analyze the potentially involved variables.METHODS: A perspective, randomized case-control study was conducted. Patients with acute primary angle-closure glaucoma(ACG)and early cataracts underwent PPI+GSL implantation(group A, n=29)and trabeculectomy(group B, n=30). The quality of life was assessed using the National Eye Institute 25-Item Visual Function Questionnaire(NEI-VFQ-25)before and 6mo after surgery. Intraocular pressure(IOP), best corrected visual acuity(BCVA), review frequency and the basic characteristics were recorded simultaneously.RESULTS: Compared with preoperative status, the IOP in both groups was significantly decreased(all P0.05). Besides, group B presented higher review frequency than group A(P<0.05). Moreover, significant increases in postoperative scores were founded in the two groups respectively(all P<0.05). Compared with group B, group A had better postoperative performance in items of general vision, ocular pain, long-distance activities, social functioning and role limitations(all P<0.05). Besides, group A presented significantly higher net increases in postoperative total scores than group B(P<0.05), which was positively associated with the degree of the BCVA recovery and negatively associated with review frequency(R2=0.48, F=5.00, P<0.05).CONCLUSION: APACG patients with early cataracts, PPI+GSL determines better improvement in quality of life compared to trabeculectomy.

Keywords

• acute primary angle-closure glaucoma
• cataracts
• phacoemulsification combined with goniosynechialysis
• trabeculectomy
• quality of life.