Efficacy of Phacoemulsification combined with different auxiliary surgeries in the treatment of primary angle closure glaucoma and cataract: A retrospective study

Abstract

Objective: To evaluate and compare the clinical outcomes of phacoemulsification (PE) combined with trabeculectomy (TB) versus PE combined with goniosynechialysis (GSL) in managing primary angle-closure glaucoma (PACG) coexisting with cataract.

Methodology: This clinical research was designed as a retrospective study, including 71 patients with PACG and cataract who underwent surgical treatment at Zibo Center Hospital between October 2023 and May 2025. Among them, 37 patients (37 eyes) underwent PE and intraocular lens implantation combined with TB (PE+TB group), and 34 patients (34 eyes) underwent PE and intraocular lens implantation combined with goniosynechialysis (PE+GSL group). Patients were followed up for 12 weeks after surgery to assess intraocular pressure (IOP), best-corrected visual acuity (BCVA), central anterior chamber depth (CACD), corneal endothelial cell counts (ECCs), and the incidence of postoperative complications.

Results: After surgery, IOP, BCVA, CACD, and ECCs improved significantly from baseline in both groups. However, between-group comparison showed a statistically significant difference only in IOP, which was lower in the PE+TB group than in the PE+GSL group (P<0.05), whereas BCVA, CACD, and ECCs were comparable between groups (all P>0.05). During postoperative follow-up, the incidence of complications in the PE+GSL group was significantly lower than that in the PE+TB group (P<0.05).

Conclusions: PE combined with either TB or GSL has its own advantages in the treatment of PACG with cataract: PE+TB results in lower IOP, while PE+GSL leads to fewer complications.