الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
Glaucoma is the leading cause of irreversible blindness. chronic angle-closure glaucoma is a form of glaucoma that develops gradually when the iris blocks the drainage angle in the anterior chamber of the eye. This blockage can lead to a slow and progressive rise in intraocular pressure, which, if left untreated, may result in vision loss. Unlike acute angle-closure glaucoma, which is a sudden and severe condition, chronic angle-closure glaucoma often does not present symptoms until significant damage has occurred.
The exact causes of chronic angle-closure glaucoma are not fully understood, but it may involve factors such as increased lens thickness, an abnormally thick iris, or an iris with a plateau iris configuration, which can all contribute to the narrowing of the drainage angle.
A comprehensive eye exam is necessary to diagnose chronic angle-closure glaucoma. Simple glaucoma screenings are insufficient to detect this condition.
This thesis presents a comparative study between two surgical techniques for managing advanced chronic angle closure glaucoma, phacoemulsification with 120 degree trabeculotomy and phacoemulsification 360 degrees trabeculotomy. The study aims to determine which method is more effective in improving vision and controlling intraocular pressure. The outcomes were evaluated based on multiple criteria, including the success rate of the surgery, reduction of IOP, BCVA, reduction in anti-glaucoma medication use, and the incidence of complications. Records of 40 cases diagnosed with advanced chronic angle closure glaucoma were reviewed half of them went for phacotrabeculotomy 120o and the other half went for phacotrabeculotomy 360o.
The results showed that both techniques significantly improve vision, but the 360o trabeculotomy may offer additional benefits in reducing the need for eye drops and improving the drainage of intraocular fluids. Mean postoperative IOP in phacotrabeculotomy 360o was 9 mmhg in opposite to 11.5 mmhg after phacotrabeculotomy 120o. Mean BCVA in phacotrabeculotomy 360o was 0.44 while in 120o group was 0.4. Both techniques were safe with no serious complication postoperative.
The study suggests that the choice of technique should be based on a careful assessment of the patient’s condition and a thorough discussion between the doctor and the patient regarding the desired outcomes of the surgery and the potential risks.