Early lens extraction to control intraocular pressure in primary angle closure
Keywords:
intraocular pressure, primary angle closure, lens, crystalline, phacoemulsification, laser therapyAbstract
Introduction: laser peripheral iridotomy is considered the first line of treatment for primary angle closure; although, there may be progression of the disease. Clear lens extraction is considered if there is intraocular pressure greater than or equal to 30 mm Hg or glaucoma damage; however, the aspects related to intraocular pressure stability over time and the impact on disease progression are unknown.
Objective: to evaluate the effectiveness of early lens extraction for intraocular pressure control as a method of preventing glaucomatous damage in patients with primary angle closure.
Methods: it was carried out a quasi-experimental study between January 2013 and January 2020; the study included 78 eyes of 78 patients with primary angle closure treated with early lens extraction (PHACO group) and 118 eyes of 66 patients treated with laser peripheral iridotomy in a previous two-year period (LPI group, historical control). For the statistical analysis, they were used Chi-square test of independence, Fisher's exact probability, analysis of variance of repeated measures and non-parametric tests; with statistical significance of 95%.
Results: there was greater IOP control with stability over time, regardless of preoperative values in the PHACO group, where there was less need for ocular hypotensive medications and other treatments. In eyes treated with LPI, they were found differences between IOP control and preoperative values for both eyes. In five years, the progression of the disease showed highly significant statistical differences (p < 0,001) between both groups. Conclusions: early extraction of the lens is an effective surgical option for the control of intraocular pressure as a method of preventing glaucomatous damage in patients with primary angle closure.
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