Fatma Isil Sozen-Delil, Şaban Şimşek
Turkish Journal of Clinical and Experimental Ophthalmology - 2025;20(3):159-167
Purpose: We aim to evaluate the follow-up outcomes of phacoemulsification inpatients who presented with acute primary angle-closure glaucoma (PACG) and to identify factors influencing the final intraocular pressure (IOP) levels in these patients. Materials and Methods: Patients diagnosed with acute PACG with an initial IOP >= 40 mmHg and no secondary ocular conditions who underwent phacoemulsification were retrospectively reviewed. Surgical success was defined as IOP levels ranging between 5 and 22 mm Hg at the final postoperative visit, regardless of topical treatment. Results: The study included 36 eyes of 32 patients with a mean age of 63+/-10 (37-91) years and a mean follow-up duration of 21.8+/-15.8 months. Postoperative IOP at the final visit was significantly lower compared to preoperative levels [14 (6-44) mm Hg vs. 44.5 (40-58) mm Hg, P<0.001]. Additionally, postoperative best-corrected visual acuity significantly improved compared to preoperative values [0.5 (0.1-3.0) LogMAR vs. 1.3 (0.2-2.7) LogMAR, P<0.001]. When comparing preoperative and postoperative IOP levels between genders, no significant differences were observed (P>0.05), and preoperative laser peripheral iridotomy (LPI) also did not affect either preoperative or postoperative IOP levels (P>0.05). Surgical complications occurred in 22.2% of cases, with a surgical success rate of 88.9%. Trabeculectomy was required in two eyes, transscleral diode laser cyclophotocoagulation in one, and blindness occurred in another. Conclusion: Phacoemulsification surgery for treating acute PACG provides both rapid and effective IOP reduction and improved visual acuity. IOP levels and LPI do not appear to influence surgical success in acute cases.
