Vitreous Decompression Combined with Phacoemulsification for Medically Unresponsive Acute Angle Closure

The management of acute angle closure combined with an extremely shallow anterior chamber and cataract remains complex. This study evaluated a technique of vitreous needle aspiration combined with phacoemulsification for the treatment of acute angle closure with continuous high intraocular pressure...

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Bibliographic Details
Main Authors: Xiaoli Xiang, Yuan Chen, Jinyu Wang, Zhengru Huang, Zheng Gu
Format: Article
Language:English
Published: Wiley 2021-01-01
Series:Journal of Ophthalmology
Online Access:http://dx.doi.org/10.1155/2021/5528281
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Summary:The management of acute angle closure combined with an extremely shallow anterior chamber and cataract remains complex. This study evaluated a technique of vitreous needle aspiration combined with phacoemulsification for the treatment of acute angle closure with continuous high intraocular pressure (IOP). We retrospectively reviewed the results of vitreous needle aspiration combined with phacoemulsification in 17 eyes (17 patients) with acute angle closure with continuous high IOP and coexisting visually significant cataracts between September 2018 and April 2020 at the glaucoma unit of the affiliated Changshu Hospital of Xuzhou Medical University. The main outcomes were the best corrected visual acuity (BCVA), IOP, anterior chamber depth (ACD), angle open distance 500 (AOD500), number of antiglaucoma medications, and surgery-associated complications. There were no complications during phacoemulsification and a foldable acrylic intraocular lens was implanted in the capsular bag in all 17 patients. For all patients, vitreous needle aspiration was successful at the first attempt. The BCVA improved from 2.02 ± 0.54 logMAR preoperatively to 0.73 ± 0.57 logMAR postoperatively at the final examination (p<0.001). The mean IOP was 54.47 ± 5.33 mmHg preoperatively and 15.59 ± 2.35 mmHg at the final examination (p<0.001) without any medication. The ACD was 1.70 ± 0.16 mm preoperatively and 3.35 ± 1.51 mm at the final examination (p<0.001). The AOD500 was 0.07 ± 0.02 mm preoperatively and 0.51 ± 0.04 mm at the final examination (p<0.001). Our vitreous needle aspiration technique can be performed safely in phacoemulsification for the management of acute angle closure with continuous high IOP.
ISSN:2090-004X
2090-0058