Comparative study on binocular anatomic parameters and therapeutic effect of acute angle closure glaucoma complicated with cataract

Objective To compare the difference of anatomical structure between seizer eyes and nonseizer eyes of patients with acute angle closure glaucoma (AACG) complicated with cataract, and explore the time of simple cataract extraction in AACG patients complicated with cataract.

Methods The clinical data of 30 cases (60 eyes) with AACG complicated with cataract were collected, which included one eye with acute seizer (1 or more times), contralateral eye with nonseizer, and correction vision of both eyes ≤0.3.The axis, lens thickness, angle opening distance 500 (AOD500) and anterior chamber depth (ACD) between two groups before treatment were compared.The visual acuity improvement and incidence rate of complications after treatment were compared between two groups.

Results Before treatment, there was no statistical significances in eye axis, crystal thickness and crystal thickness/eye axis between two groups (P>0.05), and the AOD500 and ACD in seizer group were greater than those in nonseizer group (P < 0.01).After treatment, the ACD in nonseizer group and seizer group was deeper than that before treatment (P < 0.01 and P < 0.05), the IOP in seizer group was lower than that before treatment (P < 0.01), and the IOP in nonseizer group was normal after treatment (P>0.05).After 5 patients without reaching the resting state in seizer group were removed, the difference of ACD between two groups was not statistically significant (P>0.05), and the AOD500 in nonseizer group was greater than that in seizer group (P < 0.05).In terms of postoperative complications, one case with posterior cataract in nonseizer group, and 1 case with posterior cataract, 2 cases with residual glaucoma and 4 cases with cataract aggravation in seizer group were found.The incidence rate of which in nonseizure group3.33% (1/30) was lower than that in seizer group23.3% (7/30) (P < 0.05).

Conclusion The peripheral angle parameter AOD500 of patients with AACG complicated with cataract in resting state of the seizer eye is significantly less than that in nonseizer eye.The cataract extraction in pre-clinical patients with AACG complicated with cataract during nonseizer can effectively reduce the incidence rate of AACG, and improve the long-term vision.