Changes in Anterior Chamber Angle and Choroidal Thickness in Patients with Primary Angle-Closure Glaucoma after Phaco-Goniosynechialysis

Abstract

We aimed to observe changes in angle width and choroidal thickness (CT) before and after phacoemulsification intraocular lens implantation (PEI) combined with goniosynechialysis (GSL) in patients with primary angle-closure glaucoma (PACG) complicated by cataracts. This prospective cohort study included 60 patients with PACG complicated by cataracts from the Department of Ophthalmology of Shaoxing People’s Hospital, China. Patients underwent PEI combined with GSL (PEI-GSL group) or laser peripheral iridotomy (LPI) followed by PEI (PEI group). Intraocular pressure (IOP) and endothelial counts were significantly decreased in both groups after surgery, while best-corrected visual acuity and central anterior chamber depth were significantly increased. However, there were no significant differences between the two groups. The opening degrees of room corners at 12, 3, 6, and 9 o’clock were recorded as AA12, AA3, AA6, and AA9, respectively. Anterior chamber depth was significantly increased postoperatively compared to preoperatively in both groups, with no significant between-group differences (all ps > 0.05). At 1, 3, and 6 months postoperatively, the width at AA12, AA3, and AA9 points was higher in the PEI-GSL group than in the PEI group (all ps < 0.05). Significant between-group differences at AA6 were observed preoperatively (p = 0.023) and at 1 (p = 0.027) and 3 (p = 0.033) months postoperatively but not at 6 months postoperatively (p = 0.055). CT was smaller postoperatively than preoperatively (all ps < 0.001). The present study suggests that patients with PACG who underwent PEI with or without GSL had reduced IOP and CT after surgery.