AIM: To investigate the effect of phacotrabeculectomy with intraocular lens implantation and trabeculectomy on the ocular surface in patients with primary angle closure glaucoma.

METHODS: We had seleted 60 eyes in 60 hospitalized patients with primary angle closure glaucoma and cataract. They were divided into group A and B randomly. Each group has 30 eyes of 30 cases. Group A was performed with phacotrabeculectomy with intraocular lens implantation and group B was performed with trabeculectomy. Ocular surface tests were performed in all subjects on the day before surgeries,1wk,1and 3mo after surgeries, respectively, including non-invasive keratograph first tear break-up time(NIKf-BUT),Schirmer's I test(SⅠt), and corneal and conjunctival lissamine green staining score.

RESULTS: The postoperative NIKf-BUT of group A and B were significantly shorter than those preoperative(all P<0.01). The NIKf-BUT of group A(2.78±1.44, 3.72±0.94, 5.95±0.81s)were significantly shorter than those of group B(4.54±1.68, 5.14±1.01, 8.34±1.15s)at the postoperative 1wk,1 and 3mo(t=-4.341,-5.636,-9.29,all P<0.05). The SⅠt of group A and group B at the postoperative 1 wk and 1 mo were significantly less than preoperative SⅠt(all P<0.01). The SⅠt of group A(8.57±2.47, 8.10±2.41mm)were significantly less than those of group B(10.07±2.07, 9.53±2.29mm)at postoperative 1wk and 1mo(t=-2.549,-2.636,all P<0.05). The postoperative corneal and conjunctival lissamine green staining score of group A and group B were significantly higher than preoperative score(all P<0.01). The score of group A(3.50±1.17, 2.27±0.91)were significantly higher than group B(2.50±1.33, 1.33±0.88)at the postoperative 1wk and 1mo(t=3.092,4.036, all P<0.01).

CONCLUSION: There was stronger effect of phacotrabeculectomy with intraocular lens implantation for the ocular surface in patients with primary angle closure glaucoma than trabeculectomy. It should be actively taken more measures to reduce damage of ocular surface during operations and to keep the stability of tear film at the postoperative stage.