만성폐쇄각녹내장 환자에서 백내장 단독수술의 효과

다국어 초록 (Multilingual Abstract)

Purpose: To investigate the effects of cataract extraction in chronic angle-closure glaucoma (CACG) patients. Methods: Sixteen eyes from 14 patients with CACG underwent phacoemulsification with posterior chamber intraocular lens (PCL) implantation (group A), and 19 eyes from 17 patients with CACG underwent cataract surgery and additional trabeculectomy (combined surgery, group B) were evaluated for visual acuity, intraocular pressure (IOP), number of glaucoma medications and surgical complications. All patients had patent peripheral iridotomy holes before cataract surgery, and a minimum 6 month follow-up period was needed. Results: The mean postoperative follow-up period was 15.6 months in group A, and 21.7 months in group B. After surgery, the IOP was significantly reduced in both groups [from 16.1 mmHg to 13.8 mmHg in group A (P=0.013), and from 16.7 mmHg to 13.2 mmHg in group B (P=0.005)], but the amount of IOP reduction was not significantly different between the two groups (P=0.401). The relative decrease in the mean number of postoperative glaucoma medications was 0.9 in group A and 1.8 in group B, but these were not significantly different (P=0.060). Conclusions: Simple cataract surgery was effective in reducing IOP as much as combined surgery in CACG patients. These results affirm that phacoemusification with PCL implantation may be considered as the first treatment in cataract and CACG patients.

참고문헌 (Reference)

1 이상협, "폐쇄각녹내장 환자에서 백내장 적출술 후 안압의 변화" 대한안과학회 42 (42): 73-78, 2001

2 Gunning FP, "Uncontrolled primary angle closure glaucoma: results of early intercapsular cataract extraction and posterior chamber lens implantation" 15 : 237-247, 1991

3 Ritch R, "The glaucoma, 2nd ed" CV Mosby 1661-1736, 1996

4 Koo BS, "The effect of extracapsular cataract extraction in patients with chronic angle-closure glaucoma combined with cataract" 37 : 1045-1053, 1996

5 Lai JSM, "The clinical outcomes of cataract extraction by phacoemulsification in eyes with primary angle-closure glaucoma (PACG) and co-existing cataract" 15 : 47-52, 2006

6 Byun SW, "Results of combined procedures versus two-stage operation using small incision in patients with cataract and glaucoma" 40 : 2561-2566, 1999

7 Krupin T, "Postoperative intraocular pressure rise in open-angle glaucoma patients after cataract or combined cataract-filtration surgery" 96 : 579-584, 1989

8 Quigley HA, "Long-term follow-up of laser iridotomy" 88 : 218-224, 1981

9 Alsagoff Z, "Long-term clinical course of primary angle-closure glaucoma in an Asian population" 107 : 2300-2304, 2000

10 Congdon N, "Issues in the epidemiology and population-based screening of primary angle-closure glaucoma" 36 : 411-423, 1992

11 Gimbel HV, "Intraocular pressure response to combined phacoemulsification and trabeculectomy ab externo versus phacoemulsification alone in primary open-angle glaucoma" 21 : 653-660, 1995

12 Gross JG, "Increased intraocular pressure in the immediate postoperative period after cataract extraction" 105 : 466-469, 1988

13 Acton J, "Extracapsular cataract extraction with posterior chamber lens implantation in primary angle-closure glaucoma" 23 : 930-934, 1997

14 Wishart PK, "Extracapsular cataract extraction and posterior chamber lens implantation in patients with primary chronic angle-closure glaucoma: effect on intraocular pressure control" 3 : 706-712, 1989

15 Savage JA, "Extracapsular cataract extraction and posterior chamber lens implantation in glaucomatous eyes" 92 : 1506-1516, 1985

16 Jay JL, "Extracapsular cataract extraction and posterior chamber intraocular lens insertion combined trabeculectomy" 69 : 487-490, 1985

17 Han CW, "Effect of YAG laser iridotomy on IOP in chronic angle-closure glaucoma" 36 : 1730-1736, 1995

18 Shaffer RM, "Comparison of cataract incidence in normal and glaucomatous population" 69 : 368-370, 1970

19 Tezel G, "Comparative results of combined procedures for glaucoma and cataract" 28 : 539-550, 1997

20 Johns GE, "Combined trabeculectomy and cataract extraction" 88 : 973-981, 1979

21 Anders N, "Combined phacoemulsification and filtering surgery with the ‘No-stich’ technique" 115 : 1245-1249, 1997

22 Shield MB, "Combined cataract extraction and guarded sclerectomy" 93 : 366-370, 1986

23 Lowe RF, "Causes of shallow anterior chamber in primary angle-closure glaucoma" 67 : 87-93, 1969

24 Nonaka A, "Cataract surgery for residual angle closure after peripheral laser iridotomy" 112 : 974-979, 2005

25 Nonaka A, "Angle widening and alteration of ciliary process configuration after cataract surgery for primary angle closure" 113 : 437-441, 2006