Preliminary Observation of Phacoemulsification Cataract Extraction with Intraocular Lens Implantation Combined with Goniosynechialysis and Goniotomy in the Treatment of Advanced Chronic Angle-Closure Glaucoma

Abstract Background To observe the clinical efficacy of phacoemulsification cataract extraction and intraocular lens implantation combined with angle separation and angle incision in the treatment of advanced chronic angle closure glaucoma. Purpose This study examines the therapeutic effects in the field of ophthalmology. Subjects and Methods Patients diagnosed with advanced chronic angle closure glaucoma who visited our hospital from January to December 2024 were included in the study. The patients were randomly divided into an observation group and a control group using a random number table method. The observation group underwent phacoemulsification cataract extraction with intraocular lens implantation (PEI) combined with goniosy necrolysis (GSL) and goniotomy (GT) under direct visualization, while the control group underwent PEI+GSS surgery. Compare the postoperative intraocular pressure, visual acuity, and incidence of complications between these two surgical plans at 7 days, 1 meter, and 3 meters after surgery. Results The results of the multivariate test showed that the intraocular pressure and visual acuity levels varied at different times, and the differences were statistically significant (F-intraocular pressure=33.416, F-visual acuity=33.416, both P<0.05). There was no interaction between time and group (P=0.370,>0.05). The analysis of intraocular pressure between different groups showed that the intraocular pressure levels at 7 days, 1 meter, and 3 meters after surgery were lower than before treatment, and the differences were statistically significant (P<0.05). The observation group was superior to the control group, and the difference was statistically significant (P<0.05). The results of visual acuity analysis between different groups showed that the visual acuity levels at 7 days, 1 meter, and 3 meters after surgery were higher than before treatment, and the difference was statistically significant (P<0.05). However, there was no statistically significant difference between the groups (P>0.05). There was no statistically significant difference (P>0.05) in the inter group and intra group comparisons of other intraocular pressure and visual acuity. Two eyes in the postoperative observation group experienced transient increase in intraocular pressure, accounting for 8.3% (2/24). After discontinuing steroids, intraocular pressure decreased. In the observation group, there were two cases of>1 degree anterior chamber bleeding after surgery, which was absorbed within 3-7 days, accounting for 8.3% (2/24). No complications such as choroidal detachment or malignant glaucoma occurred. Conclusions PEI combined with GSL and GT can significantly reduce intraocular pressure in patients with advanced chronic angle closure glaucoma, without increasing the incidence of adverse reactions, and is worthy of clinical promotion.