Phacoemulsification with Peripheral Iridectomy and Trabeculectomy: Comparing the Two Procedures in Management of Angle-Closure Glaucoma | ||||
| The Egyptian Journal of Hospital Medicine | ||||
| Article 27, Volume 75, Issue 4, April 2019, Page 2712-2719 PDF (165.36 K) | ||||
| Document Type: Original Article | ||||
| DOI: 10.21608/ejhm.2019.32062 | ||||
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| Author | ||||
Asaad Nooreldin 
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| Ophthalmology Department, Faculty of Medicine, Al-Azhar University (Assuit), Egypt | ||||
| Abstract | ||||
| Background: glaucoma was ranked as one of the major causes of blindness worldwide. Angle-closure glaucoma (ACG) is a type of glaucoma characterized by narrowing or closure of the anterior chamber angle. Objective: to compare the clinical outcomes of phacoemulsification (Phaco) with peripheral iridectomy versus trabeculectomy in management of ACG. Patients and Methods: this study was a prospective, follow-up nonrandomized clinical trial, carried out on 50 eyes with ACG. Patients were divided into two groups: group A (n= 25); eyes underwent phacoemulsification with peripheral iridectomy, and group B (n= 25); eyes underwent sub-scleral trabeculectomy. Intraocular pressure (IOP), visual outcomes and postoperative complications were assessed. Patients were followed-up for 6 months. Results: postoperative visual acuity was significantly improved in phaco group compared to that of trabeculectomy group (P <0.001). The mean postoperative IOP was reduced significantly (P < 0.05) in both groups at all time intervals compared to their preoperative values. Anterior chamber depth increased significantly postoperatively in group (A) (p<0.001) however, almost no change was noticed in group (B). Meanwhile, postoperative angle opening distance was increased (p<0.001) in both groups. No significant differences were found between both procedures in Rim area, Rim volume, cup/disc area ratio and maximum cup depth. Eight cases (32.0%) in group (A) and 7 cases (28.0%) in group (B) suffered from postoperative complications with insignificant difference. Conclusion: both procedures are effective in lowering IOP in patients with ACG, but phacoemulsification with peripheral iridectomy significantly improved visual acuity compared to sub-scleral trabeculectomy with almost the same rate of complications. | ||||
| Keywords | ||||
| Phacoemulsification; Peripheral Iridectomy; Trabeculectomy; Angle Closure-Glaucoma | ||||
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