Researchers recently discovered that early phacoemulsification with intraocular lens (IOL) implantation results in a reduction in intraocular pressure (IOP) and the number of glaucoma medications after an acute angle-closure glaucoma crisis in patients with coexisting cataract.

The retrospective study evaluated 35 patients with acute angle closure and coexisting cataract who had undergone standard treatment with topical and systemic medical therapy and laser peripheral iridotomy. The participants underwent small-incision phacoemulsification with IOL implantation into the capsular bag within three months of their acute angle-closure episode, the study notes. The team of researchers then assessed the effect of early phacoemulsification on IOP, the number of glaucoma medications, visual acuity and complications.

They found that IOP decreased in all patients from 17.0 ±8.2mm Hg to 13.2 ±3.9mm Hg after three months. The researchers note that the mean number of glaucoma medications also decreased, from 2.9 ±1.1 to 0.7 ±0.9, with 56% of patients discontinuing medication usage. They add that visual acuity improved from 0.9 ±0.9logMAR to 0.2 ±0.3logMAR, and there were no complications.

The study concludes that “although surgery may be challenging, the results are promising, with significant improvement in visual acuity in most patients.”

Römkens HCS, Beckers HJM, Schouten JSAG, et al. Early phacoemulsification after acute angle closure in patients with coexisting cataract. J Glaucoma. 2018;27(8):711-6.