25-Gauge anterior vitrectomy via the scleral flap in phacoemulsification combined with trabeculectomy for glaucoma and cataract with extremely shallow anterior chamber

Abstract Objective: To observe the safety and efficacy of a surgical technique of 25-gauge anterior vitrectomy via scleral flap in phacoemulsification combined with trabeculectomy for glaucoma and cataract with extremely shallow anterior chamber.Methods: This was a retrospective study composed with 18 eyes of 18 patinets（8 males and 10 females）, including 11 eyes with acute angle closure glaucoma, 8 eyes with lens subluxation combined with glaucoma. All patients underwent phacoemulsification, intraocular lens (IOL) implantation, trabeculectomy, and anterior vitrectomy via the scleral flap in cases where conservative managements cannot control intraocular pressure (IOP). The main outcomes were best corrected visual acuity (BCVA), anterior chamber depth (ACD), IOP, slit lamp microscopic examinations, medications, fundus examinations and complications.Results: The average axial length (AL) was 21.5 ± 0.6 mm (range: 20.0 to 23.2 mm). Mean age was 62.3 ± 7.9 years old (range: 46 to 73 years). Mean ACD increased statistically significant from 0.78 ± 0.43 mm to 2.89 ± 0.41 mm 1 week after surgery (P<0.001). Mean IOP decreased significantly from 43.28 ± 9.38 mmHg to 16.72 ± 6.28 mmHg (P<0.001). There were no serious complications occurred, such as endophthalmitis, retinal detachment, suprachoroidal hemorrhage, corneal decompensation and malignant glaucoma.Conclusions: 25-Gauge anterior vitrectomy via the scleral flap was a safe and effective technology in glaucoma combined with cataract with extremely shallow anterior chamber.