Samreen Ayubi
Glaucoma, the second leading cause of blindness worldwide, is often characterized by progressive optic nerve damage due to elevated Intraocular Pressure (IOP). Primary Angle Closure Glaucoma (PACG) results from structural anomalies that cause the iris to obstruct the trabecular meshwork, hindering aqueous humor drainage. Acute PACG attacks are typically managed with pressure-lowering medications followed by surgical interventions such as peripheral iridectomy or iridotomy. Recent studies have suggested that primary phacoemulsification and Intraocular Lens (IOL) implantation may not only resolve acute PACG attacks but also provide long-term IOP control. This prospective, non-comparative, observational study aimed to evaluate the effects of primary phacoemulsification and IOL implantation in patients with acute PACG and coexisting cataract. A total of 30 patients aged 50–80 years were enrolled, and their IOP, visual acuity, Anterior Chamber Depth (ACD), use of ant glaucoma medications, and angle opening were assessed before and after surgery. Preoperative IOP averaged 31.5 ± 13.7 mmHg, which decreased significantly to 12.83 ± 3.13 mmHg at 6 months, with a success rate of 96.66%. Visual acuity improved from 1.38 ± 0.71 LogMAR to 0.35 ± 0.16 LogMAR. The number of ant glaucoma medications decreased from 2.23 ± 0.77 preoperatively to 0.27 ± 0.52 postoperatively. Gonioscopy and ACD measurements also showed significant improvements. Few complications, such as corneal edema and iritis, were noted. The results suggest that phacoemulsification and IOL implantation is a safe and effective alternative to conventional treatments for acute PACG with cataract, providing better IOP control, visual improvement, and reduced dependence on ant glaucoma medications.
