Case report on the efficacy of phacoemulsification combined with goniosynechialysis in the treatment of advanced primary angle-closure glaucoma complicated with cataract

RATIONALE: Primary angle-closure glaucoma (PACG) is a leading cause of irreversible blindness in China, with a prevalence of as high as 1.5% in individuals over 50 years of age. Many patients are already at an advanced stage of the disease at their first clinical presentation. PATIENT CONCERNS: A retrospective analysis was performed on PACG patients who underwent PEL + GSL at Shanxi Provincial Eye Hospital from June 1, 2023, to October 1, 2023.The patient noticed a decline in their vision, a narrowing of the visual field, accompanied by discomfort such as eye distension and redness. Preoperative biometry, visual field, and (Ultrasound Biomicroscopy) UBM results were recorded, and observations were made before surgery. Visual acuity, intraocular pressure, antiglaucoma medication and complications were recorded at 1week, 1month, 3months, and 6 months. DIAGNOSES: All eyes had advanced PACG, with an average mean deviation of -25.243 ± 6.550 dB and a pattern standard deviation of 6.516 ± 3.042. 48 cases (56 eyes) were collected, ranging in age from 47 to 86 (66.62 ± 9.10) years, and 32 (66.66%) were female patients. The preoperative visual acuity was 0.375 ± 0.245, the average mean deviation of the visual field was -25.04 ± 5.59 dB, and the pattern standard deviation was 6.516 ± 3.042. INTERVENTIONS: All patients successfully underwent cataract surgery combined with goniosynechialysis. OUTCOMES: The intraocular pressure after PEL + GSL dropped from 27.84 ± 11.47 mm Hg before surgery to 13.696 ± 1.69 mm Hg at the last follow-up, the visual acuity improved from 0.375 ± 0.245 before surgery to 0.529 ± 0.210, and the antiglaucoma drugs decreased from 2.52 ± 0.50 before surgery to 0.11 ± 0.37. LESSONS: PEL + GSL is an effective method for the treatment of advanced PACG combined with cataract, which can significantly reduce intraocular pressure with few complications.