To evaluate the intraoperative and postoperative complications and outcomes of phacoemulsification of cataract in eyes with prior iriodotomy for acute angle closure glaucoma.

This retrospective case-control study included 30 eyes which underwent phacoemulsification. All 30 eyes had prior acute angle closure treated by laser iridotomy (ACG group). A second group that had phacoemusification for cataract only served as control (Control group).

The ACG group showed significantly shallow anterior chamber (1.56±0.18 mm) and short axial length (22.32±0.60 mm). At 2 months after surgery, visual acuity was improved in both groups and IOP was significantly decreased in the ACG group. Posterior synechiae, small pupil and zonulysis were more commonly found in the ACG group than the control group. Intraoperative iris trauma and postoperative persistent mydriasis were also more common in the ACG group.

During cataract surgery in eyes with prior iriodotomy for acute angle closure glaucoma, there are many preoperative risk factors such as shallow anterior chamber, zonulysis, and small pupil. These increase the risk of posterior capsule rupture and bullous keratopathy. To reduce the complications and improve the visual acuity, a careful preoperative examination and proper intra- and post-operative management by skillful surgeons are needed.