Role of phacoemulsification as a treatment modality in patients of acute primary angle closure glaucoma with co-existing cataract

Abstract Purpose: To determine the role of phacoemulsification with intraocular lens (IOL) implantation as a treatment modality in eyes with primary angle closure glaucoma (PACG) with co-existing cataract. Materials and Methods: Thirty eyes of 30 patients with PACG, meeting the inclusion criteria, underwent phacoemulsification with IOL implantation as primary treatment for medically uncontrolled intraocular pressure (IOP). The clinical outcomes were determined in terms of IOP control, vision improvement, need for antiglaucoma medications, gonioscopy grading, and changes in anterior chamber depth (ACD). Results: Among the subjects studied, mean preoperative IOP was 31.5 ± 13.678 mm Hg, which reduced to 12.83 ± 3.13 mm Hg 6 months after the operation. Visual acuity increased from preoperative FC 1m – 6/24 to postoperative 6/18 – 6/9, which was statistically significant. Mean number of antiglaucoma medications required decreased from 2.23 ± 0.77 to 0.27 ± 0.52 ( P < 0.01). Mean ACD increased from 1.97 ± 0.13 to 3.08 ± 0.15 ( P < 0.01). Mean Schaffer gonioscopy grading increased from 0.94 ± 0.62 to 2.61 ± 0.44 ( P < 0.01). Conclusions: Primary phacoemulsification with IOL implantation is a safe and effective method and can be considered a first-line treatment option in managing acute PACG patients.