Comparison of Outcomes of Phacoemulsification with MIGS versus Phacoemulsification in Primary Angle Closure Disease

Project Summary:

This prospective, comparative study aims to evaluate the outcomes of Phacoemulsification with Minimally Invasive Glaucoma Surgery (MIGS) versus Phacoemulsification alone in patients with Primary Angle Closure Disease (PACD). Glaucoma is the second leading cause of irreversible blindness worldwide, with PACD being particularly prevalent and severe in Asians. While phacoemulsification can effectively open the anterior chamber angle, the additional role of MIGS in enhancing intraocular pressure (IOP) control remains underexplored.

A total of 40 participants (aged 40 to 80 years) with PAC or PACG on anti-glaucoma medications and visually significant cataract will be recruited at Aravind Eye Hospital, Chennai, and assigned to two equal groups: Group A (Phaco and MIGS) and Group B (Phaco alone). The primary outcome is IOP reduction, with secondary outcomes including reduction in glaucoma medications and postoperative complications. Success is defined as more than or equal to 20% IOP reduction or reduction of at least one medication without the need for additional surgical/laser interventions.

The study will provide evidence on whether combining MIGS with phacoemulsification offers superior pressure control and reduced medication dependence, potentially improving long-term vision outcomes and quality of life in PACD patients. Ethical approval will be obtained, informed consent ensured, and participant confidentiality maintained.

This prospective, comparative study aims to evaluate the outcomes of Phacoemulsification with Minimally Invasive Glaucoma Surgery (MIGS) versus Phacoemulsification alone in patients with Primary Angle Closure Disease (PACD). Glaucoma is the second leading cause of irreversible blindness worldwide, with PACD being particularly prevalent and severe in Asians. While phacoemulsification can effectively open the anterior chamber angle, the additional role of MIGS in enhancing intraocular pressure (IOP) control remains underexplored.

A total of 40 participants (aged 40–80 years) with PAC or PACG on anti-glaucoma medications and visually significant cataract will be recruited at Aravind Eye Hospital, Chennai, and assigned to two equal groups: Group A (Phaco and MIGS) and Group B (Phaco alone). The primary outcome is IOP reduction, with secondary outcomes including reduction in glaucoma medications and postoperative complications. Success is defined as more than or equal to 20% IOP reduction or reduction of at least one medication without the need for additional surgical/laser interventions.

The study will provide evidence on whether combining MIGS with phacoemulsification offers superior pressure control and reduced medication dependence, potentially improving long-term vision outcomes and quality of life in PACD patients. Ethical approval is obtained, informed consent will be ensured, and participant confidentiality maintained.