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Phacoemulsification in eyes previously treated for acute primary angle closure: incidence, complication rates and outcomes

Poster Details

First Author: P.Rainsbury UK

Co Author(s):    S. Begum   G. Hunter   J. Kirwan              

Abstract Details


To investigate the incidence, complication rates, and outcomes of patients undergoing cataract surgery with a previous history of acute primary angle closure (APAC) treated with laser peripheral iridotomy.


The study was carried out at Queen Alexandra Hospital, Porstmouth, UK, a large district general hospital serving a polulation of 600,000 people.


A retrospective study was performed using electronic medical records to find cases of APAC presenting between January 2007 and October 2014 treated with phacoemulsification and intraocular lens placement within 6 months of their presentation with APAC. Surgery was carried out by a consultant ophthalmic surgeon, or by a trainee surgeon with 2 or more years of experience.


85 cases of APAC were treated over the study period, of which 46 underwent cataract surgery. Significant complications occurred in 4 cases (2 cases of vitreous loss requiring anterior vitrectomy, 1 zonular dehiscence without vitreous loss and 1 iris trauma from the phacoemulsification tip). The complication rate was significantly higher in trainee surgeons (3/4 complications) than consultant surgeons. Postoperatively the mean potoperative visual acuity at ≥3 weeks was 0.34 and the mean improvement of vision was 9 LogMAR letters. 41% of cases were within 0.5D of the planned refraction and 83% were within 1D.


Cataract surgery is commonly performed in patients shortly after APAC, and is a technically challenging operation with an increased rate of complications, particularly if carried out by a trainee surgeon. Short term visual acuity improvement is limited.

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