การเปรียบเทียบระดับการมองเห็น ความดันลูกตา และ ปริมาณการใช้ยา ก่อนและหลังการผ่าตัดเปลี่ยนเลนส์เทียมในผู้ป่วยต้อหินมุมปิด

Akkaranisorn  Dechkong

Authors

Akkaranisorn Dechkong Division of Ophthalmology Prachuap Khiri Khan Hospital

Keywords:

Primary angle-closure glaucoma, Cataract extraction with intraocular lens implantation in primary angle closure glaucoma patients

Abstract

Background: Primary angle-closure glaucoma (PACG) can be managed using various treatment modalities, including medications and laser therapy. However, in patients whose intraocular pressure remains uncontrolled, lens extraction with intraocular lens implantation has recently been recognized as an effective surgical treatment for PACG.

Objective: To evaluate the effectiveness of intraocular lens implantation surgery in patients with primary angle-closure glaucoma (PACG) who had previously been treated with antiglaucoma medications and/or laser therapy, focusing on improvements in visual acuity, reduction of intraocular pressure (IOP), and decreased use of antiglaucoma medications.

Methods: This preliminary experimental study employed a one-group pretest–posttest design. The study population consisted of patients with PACG who attended the ophthalmology clinic at Prachuap Khiri Khan Hospital and were treated with antiglaucoma medications and/or laser therapy, followed by cataract extraction with intraocular lens implantation. Data were collected from October 20, 2024, to January 20, 2025. A total of 31 eyes were included in the study. Descriptive statistics, including percentages, means, and standard deviations, were used for data analysis. Inferential statistics included the Friedman test and Wilcoxon Signed Ranks Test.

Results: The median visual acuity significantly improved after intraocular lens implantation surgery. When compared across follow-up periods at 1 week, 1 month, and 3 months postoperatively, visual acuity showed statistically significant improvement over time. The median intraocular pressure and the number of antiglaucoma medications used were significantly reduced at 1 week after surgery. However, no statistically significant differences in median intraocular pressure or medication use were observed between the 1 month and 3 month follow-up periods.

Conclusion: Cataract extraction with intraocular lens implantation in patients with primary angle closure glaucoma is an effective treatment modality. The procedure effectively reduces intraocular pressure, decreases dependence on antiglaucoma medications, and improves visual acuity, leading to better disease control and enhanced quality of life for patients.

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