Phacoemulsification and intraocular lens implantation for acute angle closure not treated or previously treated by laser iridotomy

PurposeTo determine the effect of phacoemulsification, aspiration, and intraocular lens (IOL) implantation in eyes with acute angle closure or eyes with prior laser iridotomy for acute angle closure.SettingDepartment of Ophthalmology, Oita Prefectural Hospital, Oita, Japan.MethodsEighteen eyes with acute angle closure and 8 eyes with cataracts that had a prior acute angle closure treated by laser iridotomy had phacoemulsification, aspiration, and IOL. A third group that had phacoemulsification, aspiration, and IOL for cataracts only served as controls. The preoperative and postoperative intraocular pressures (IOPs), visual acuities, and number of antiglaucoma medications were compared between these 3 groups.ResultsThe mean IOPs in the eyes with phacoemulsification, aspiration, and IOL alone and the eyes with prior acute angle closure treated by laser iridotomy were decreased significantly after phacoemulsification, aspiration, and IOL. The mean IOPs in the control group also decreased, but not significantly. There was no significant difference in the postoperative IOP between the 3 groups. The postoperative visual acuities were improved significantly in the 3 groups, and the differences in the final visual acuities were not significant. Postoperatively, the antiglaucoma medication was not needed in the phacoemulsification, aspiration, and IOL-alone group, but medication was necessary in eyes treated previously with laser iridotomy.ConclusionPhacoemulsification with IOL implantation lowered IOP, improved visual acuity, and diminished the need for antiglaucoma medication in eyes with acute angle closure and with a prior acute angle closure treated by laser iridotomy.