Aim: To evaluate the phacoemulsification results of patients with primary angle closure (PAC) and primary angle closure glaucoma (PACG) using the Pentacam system. Method: This retrospective cohort study included patients with PAC and PACG who underwent phacoemulsification and intraocular lens implantation between 2018 and 2021 in one tertiary center. Anterior chamber parameters measured using the Pentacam system and gonioscopic and intraocular pressure (IOP) changes were evaluated preoperatively and postoperatively. Results: Nineteen eyes of 13 patients with PAC and PACG were included in the study. The mean age of the patients was 63.2 years, and 30.8% were male. The mean preoperative and postoperative third-month IOP was 21.0 ± 7.4 mmHg (11-40) and 13.7± 2.5 mmHg (9-18), respectively (p < 0.01). The mean preoperative anterior chamber angle (ACA) measured by the Pentacam system was 21.07 ± 4.16° (13-27). The mean preoperative anterior chamber depth (ACD) and the anterior chamber volume (ACV) measured by the Pentacam system were 1.79 ± 0.24 mm (1.39-2.22) and 72.55 ± 20.64 mm3 (45-109), respectively. The postoperative third-month topographic measurements were as follows: mean angle, 35.76 ± 7.32° (20.1-46.9); mean ACD, 3.52 ± 0.95 mm (1.15-4.46); and mean ACV, 133.21 ± 25.21 mm3 (81-173) (p < 0.01). Conclusion: Pentacam is a useful system to evaluate anterior segment changes after phacoemulsification in patients with PAC and PACG. Phacoemulsification was found to result in significant IOP reduction in these patients.
Purpose: To analyze the long-term results of trabectome surgery and to characterize risk factors for failure.Method: This is a single-center retrospective study including 66 eyes of 56 patients who underwent trabectome alone (TA) or phacotrabectome (TP) surgeries between 2012-2016. Surgical success was defined as intraocular pressure (IOP) drop by 20% or IOP ≤21 mmHg and no further glaucoma surgery. Risk factors for further surgeries were analyzed with Cox proportional hazard ratio models. Cumulative success analysis of subgroups was completed with the Kaplan Meier analysis.Results: Mean follow-up period was 59.7±14.1 months. During the follow-up period, 15 of 62 (24.2%) eyes had additional glaucoma surgery. The mean preoperative IOP was 26.8±6.5 mmHg. The mean last visit IOP was 18.7±4.5 mmHg (p<0.01). IOP decreased 30.1% from baseline at the last visit. Average numbers of medications used were 3.42 ±0.76 (range 1-4) and 2.45±1.33 (range 0-4) at preoperative and last visit, respectively (p<0.01). The risk factors for further surgery requirements were higher baseline IOP (HR:1.12, p:0.01), higher central corneal thickness (CCT) (HR:1.01, p:0.04), and higher amounts of preoperative drugs (HR:2.22, p:0.08). The cumulative probability of success was 93.5%, 90.5%, 85.5%, 80.6%, and 77.4% at 3, 12, 24, 36, and 60 months, respectively. Kaplan Meier survival plots indicating the time of additional glaucoma surgery in the subgroups showed higher survival probability in primary open angle glaucoma (POAG), males, phacotrabectome cases, early stage glaucoma, and eyes without previous glaucoma surgery. Conclusion: Trabectome success ratio was 50% at 59 months. Higher baseline IOP and thicker CCT are associated with an increased risk of further glaucoma surgery.
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