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

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• 作者：Xiaofei Man ; Noel C. Y. Chan ; Nafees Baig…
• 关键词：Primary angle ; closure glaucoma ; Clear lens extraction ; Phacoemulsification ; Trabeculectomy ; Ultrasound biomicroscopy ; Gonioscopy
• 刊名：Graefe's Archive for Clinical and Experimental Ophthalmology
• 出版年：2015
• 出版时间：May 2015
• 年：2015
• 卷：253
• 期：5
• 页码：773-778
• 全文大小：283 KB
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  3.Tham CC, Kwong YY, Leung DY et al (2009) Phacoemulsification versus combined phacotrabeculectomy in medically uncontrolled chronic angle closure glaucoma with cataract. Ophthalmology 116:725-31. doi:10.-016/?j.?ophtha.-2.-54 View Article PubMed
  4.Tham CC, Kwong YY, Leung DY et al (2010) Phacoemulsification vs phacotrabeculectomy in chronic angle-closure glaucoma with cataract: complications [corrected]. Arch Ophthalmol 128:303-11. doi:10.-001/?archophthalmol.-2 View Article PubMed
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  7.Tham CC, Kwong YY, Baig N et al (2013) Phacoemulsification versus trabeculectomy in medically uncontrolled chronic angle-closure glaucoma without cataract. Ophthalmology 120:62-7. doi:10.-016/?j.?ophtha.-7.-21 View Article PubMed
  8.Tham CC, Leung DY, Kwong YY et al (2010) Effects of phacoemulsification versus combined phaco-trabeculectomy on drainage angle status in primary angle closure glaucoma (PACG). J Glaucoma 19:119-23. doi:10.-097/?IJG.-b013e31819d5d0c-/span> View Article PubMed
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• 作者单位：Xiaofei Man (1) (2)
  Noel C. Y. Chan (1) (3)
  Nafees Baig (1) (3)
  Yolanda Y. Y. Kwong (1) (3) (4)
  Dexter Y. L. Leung (1) (3)
  Felix C. H. Li (1) (3)
  Clement C. Y. Tham (1) (3) (4) (5)
  
  1. Department of Ophthalmology & Visual Sciences, The Chinese University of Hong Kong, Hong Kong SAR, People’s Republic of China
  2. Department of Ophthalmology, Xin Hua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, People’s Republic of China
  3. Hong Kong Eye Hospital, Kowloon, Hong Kong SAR, People’s Republic of China
  4. Prince of Wales Hospital, New Territories, Shatin, Hong Kong SAR, People’s Republic of China
  5. Ophthalmology & Visual Sciences, The Chinese University of Hong Kong, Hong Kong Eye Hospital, 147K Argyle Street, Kowloon, Hong Kong, People’s Republic of China
  
• 刊物类别：Medicine
• 刊物主题：Medicine & Public Health
  Ophthalmology
  
• 出版者：Springer Berlin / Heidelberg
• ISSN：1435-702X

文摘

Purpose To document the anatomical effects of clear lens extraction by phacoemulsification versus trabeculectomy on anterior chamber angle in patients with primary angle-closure glaucoma (PACG). Methods Gonioscopy and ultrasound biomicroscopy (UBM) were performed pre-operatively, and at 1?year after clear lens extraction or trabeculectomy in PACG eyes. Results Fifty PACG eyes of 50 patients were included. Twenty-six eyes had clear lens extraction by phacoemulsification, while 24?eyes underwent trabeculectomy. The mean extent of synechial angle closure was significantly reduced from 272.3°?±-7.3° to 253.3°?±-0.5° (p--.007) by phacoemulsification, but it was only reduced from 285.0°?±-4.6° to 283.1°?±-5.5° (p--.32) by trabeculectomy. The mean angle-opening distance at 500 microns from sclera spur (AOD500) measured by UBM was significantly increased from 220.3?±-3.8 microns to 388.9?±-34.1 microns (p-lt;-.001) by clear lens extraction, but decreased from 220.9?±-9.8 microns to 214.5?±-0.2 microns (p--.11) by trabeculectomy. The mean anterior chamber depth (ACD) measured by UBM was significantly increased from 1,983.8?±-76.8 microns to 3335.0?±-74.2 microns (p-lt;-.001) by clear lens extraction, but decreased from 2,000.2?±-14.5 microns to 1975.8?±-18.2 microns (p--.001) by trabeculectomy. Conclusion 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.