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Précis <p>Treatment of acute angle-closure glaucoma with phacoemulsification combined with goniosynechialysis significantly improves patients’ visual acuity and reduce intraocular pressure; the preoperative condition has minimal influence on the treatment outcome.</p> Purpose <p>The study aimed to treat acute angle-closure glaucoma and explore the structural differences of the anterior segment as well as the influence of persistent high intraocular pressure on surgical outcomes.</p> Methods <p>This retrospective case-control study included 120 patients (122 eyes) with acute angle-closure glaucoma, divided into two groups based on intraocular pressure two hours post-drug treatment: a normotensive group (21 mmHg or below; 54 subjects/55 eyes) and a hypertensive group (&gt; 21 mmHg; 66 patients/67 eyes). Anterior segment structures, corneal endothelial cell density, and other parameters were systematically analyzed. All patients underwent phacoemulsification combined with goniosynechialysis. Statistical analysis employed independent-samples t-tests, Mann-Whitney U tests, and Wilcoxon signed-rank tests, as appropriate.</p> Results <p>There was no significant difference in the anterior segment structure between the two groups (<i>P</i> &gt; 0.05) except for anterior chamber depth (t = -2.541, <i>P</i> = 0.012). Corneal endothelial cell density was significantly higher in the normotensive group than in the hypertensive group (Z = -0.399, <i>P</i> = 0.026).Postoperative visual acuity improved in both groups (Z = -8.663, <i>P</i> &lt; 0.01), but no significant intergroup difference was observed (Z = -1.201, <i>P</i> = 0.23).Intraocular pressure decreased significantly in both groups (t = 25.901, <i>P</i> &lt; 0.01). with a more pronounced reduction in the hypertensive group (Z = -3.387, <i>P</i> = 0.01).</p> Conclusions <p>In medically treated acute angle-closure glaucoma, anterior chamber depth differed significantly between the normotensive and hypertensive groups ( <i>P</i> = 0.012), whereas no significant differences were observed in other anterior segment parameters (<i>P</i> &gt; 0.05). Following phacoemulsification combined with goniosynechialysis, both visual acuity and intraocular improved. Preoperative persistent high intraocular pressure has no significant effect on surgical outcomes.</p>

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Phacoemulsification combined with goniosynechialysis for acute angle-closure glaucoma: impact of preoperative IOP status

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年11月7日

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  • Chan Xiong,
  • Yangyang Dai,
  • Hai He,
  • Hongdou Luo,
  • Haina Zheng,
  • Xueqing Yu,
  • Lu Yang,
  • Xu Zhang,
  • Zhipeng You

摘要

Précis

Treatment of acute angle-closure glaucoma with phacoemulsification combined with goniosynechialysis significantly improves patients’ visual acuity and reduce intraocular pressure; the preoperative condition has minimal influence on the treatment outcome.

Purpose

The study aimed to treat acute angle-closure glaucoma and explore the structural differences of the anterior segment as well as the influence of persistent high intraocular pressure on surgical outcomes.

Methods

This retrospective case-control study included 120 patients (122 eyes) with acute angle-closure glaucoma, divided into two groups based on intraocular pressure two hours post-drug treatment: a normotensive group (21 mmHg or below; 54 subjects/55 eyes) and a hypertensive group (> 21 mmHg; 66 patients/67 eyes). Anterior segment structures, corneal endothelial cell density, and other parameters were systematically analyzed. All patients underwent phacoemulsification combined with goniosynechialysis. Statistical analysis employed independent-samples t-tests, Mann-Whitney U tests, and Wilcoxon signed-rank tests, as appropriate.

Results

There was no significant difference in the anterior segment structure between the two groups (P > 0.05) except for anterior chamber depth (t = -2.541, P = 0.012). Corneal endothelial cell density was significantly higher in the normotensive group than in the hypertensive group (Z = -0.399, P = 0.026).Postoperative visual acuity improved in both groups (Z = -8.663, P < 0.01), but no significant intergroup difference was observed (Z = -1.201, P = 0.23).Intraocular pressure decreased significantly in both groups (t = 25.901, P < 0.01). with a more pronounced reduction in the hypertensive group (Z = -3.387, P = 0.01).

Conclusions

In medically treated acute angle-closure glaucoma, anterior chamber depth differed significantly between the normotensive and hypertensive groups ( P = 0.012), whereas no significant differences were observed in other anterior segment parameters (P > 0.05). Following phacoemulsification combined with goniosynechialysis, both visual acuity and intraocular improved. Preoperative persistent high intraocular pressure has no significant effect on surgical outcomes.