Purpose

To compare the effect on intraocular pressure (IOP) of phacoemulsification combined with viscosynechialysis and trabeculotomy with that of phacoemulsification combined with trabeculectomy in eyes with primary angle-closure glaucoma (PACG) and visually significant cataract.

Setting

Mansoura Ophthalmic Center, Mansoura University, Egypt.

Design

Prospective case series.

Methods

This prospective randomized study included patients with uncontrolled PACG and visually significant cataract presenting between 2012 and 2017. The eyes were randomized to phacoemulsification combined with viscosynechialysis and trabeculotomy (phaco–viscosynechialysis group) or phacoemulsification combined with trabeculectomy (phacotrabeculectomy group). Success (true and qualified) (IOP <18 mm Hg without sight-threatening complications) was studied 24 months postoperatively. Intraoperative complications were noted. The primary outcome measure was the IOP before and after surgery.

Results

The study comprised 59 eyes of 59 patients with a mean age of 59.8 years ± 6.8 (SD) in the phaco–viscosynechialysis group (30 eyes) and 60.3 ± 6.3 years in the phacotrabeculectomy group (29 eyes) (P = .704). The mean preoperative IOP was 28.7 ± 2.14 mm Hg in the phaco–viscosynechialysis group and 28.5 ± 2.11 mm Hg in the phacotrabeculectomy group; the mean at 24 months was 14.5 ± 2.8 mm Hg and 17.3 ± 2.2 mm Hg, respectively (P < .001). The total success rate at 24 months was 90% and 83%, respectively.

Conclusion

Although both techniques were relatively safe and effective in reducing IOP for at least 2 years in eyes with PACG, combined phacoemulsification–viscosynechialysis–trabeculotomy gave better outcomes.

中文翻译：

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白内障混控白内障超声乳化联合黏膜全刀切开联合小梁切除术治疗原发性闭角型青光眼白内障

目的

为了比较在原发性闭角型青光眼（PACG）和视觉上显着的白内障的超声乳化联合粘膜黏膜松解术和小梁切开术对眼内压（IOP）的影响。

设置

埃及曼苏拉大学曼苏拉眼科中心。

设计

预期案例系列。

方法

这项前瞻性随机研究纳入了2012年至2017年期间出现PACG失控且在视觉上有明显白内障的患者。将眼睛随机分为超声乳化联合粘膜黏膜松解术和小梁切开术（超声乳化粘膜粘连术组）或超声乳化联合小梁切除术（超声乳化小梁切除术组）。术后24个月研究成功（真实和合格）（IOP <18 mm Hg，无视觉威胁并发症）。注意到术中并发症。主要结局指标是手术前后的眼压。

结果

这项研究由59例患者的59眼组成，超声乳化粘膜粘连分析组（30眼）的平均年龄为59.8岁±6.8（标准差），在超声小梁切除术组（29眼）中的平均年龄为60.3±6.3岁（P  = .704）。晶状体-黏膜粘连分析组的平均术前眼压为28.7±2.14 mm Hg，超声小梁切除术组的平均术前眼压为28.5±2.11 mm Hg。24个月时的平均值分别为14.5±2.8 mm Hg和17.3±2.2 mm Hg（P  <.001）。24个月的总成功率分别为90％和83％。

结论

尽管两种技术在使用PACG的眼中至少2年内都可以安全且有效地降低IOP，但联合超声乳化-粘膜全神经刀切开-小梁切开术可带来更好的效果。