METHODS: Totally 85 elderly cataract patients(85 eyes)with acute PACG admitted between January 2017 and July 2020 were enrolled. According to the operation method, they were divided into study group(46 cases, 46 eyes)and control group(39 cases, 39 eyes). The control group was treated with 1.8mm microincision phacoemulsification and ultra-thin artificial lens implantation, while the study group was treated with trabeculectomy on the basis of the treatment of control group. The best corrected visual acuity(BCVA), intraocular pressure, anterior chamber angle width classification, corneal endothelial cell count and surgical complications of the two groups were compared.

RESULTS: Compared with the same group before operation, the BCVA(LogMAR)of the two groups was significantly reduced at 1, 3 and 6mo after operation(all P<0.05), and the study group had lower LogMAR BCVA than the control group(all P<0.05). At 1, 3 and 6mo after operation, intraocular pressure of the two groups was significantly reduced(P<0.05), and the study group had lower intraocular pressure than the control group(P<0.05). Meanwhile, the proportion of anterior chamber angle width grade NⅠwas increased, and the proportion of grade N Ⅳ was reduced in the two groups(P<0.05). The proportion of grade NⅠwas higher in the study group than in the control group(P<0.05). No significant differences were found between the two groups in terms of corneal endothelial cell count(P>0.05)and the incidence of complications(28% vs 26%; P>0.05).

CONCLUSION: For patients with senile cataract complicated with acute PACG, trabeculectomy based on microincision phacoemulsification and ultra-thin artificial lens implantation can significantly lower intraocular pressure, relieve glaucoma, and reduce visual impairment, with little damage to corneal endothelial cells and few complications. Besides, the clinical effect is marked.