Abstract: Objective To analyze the therapeutic effect of improved pars plana vitreous drainage in the combined surgery of glaucoma and cataract for angle closure glaucoma with abnormal lens suspensory ligament. Design Retrospective case series. Participants 18 patients (18 eyes) with angle closure glaucoma with abnormal lens suspension ligament were reviewed from January 2021 to February 2023 in Beijing Tongren Hospital. Methods All patients were treated with improved pars plana vitreous drainage, phacoemulsification and cataract extraction. All patients were implanted with intraocular lens (IOL) in the bag at the first stage. All patients were treated with wide base peripheral iridectomy. 11 patients were implanted with capsular tension ring, 5 patients with trabeculectomy, and 3 patients with ciliary body photocoagulation under endoscope. The average postoperative follow-up was (8.3±3.6) months. Main Outcome Measures Anterior chamber depth (ACD), visual acuity (VA), intraocular pressure (IOP), number of anti glaucoma drugs used, and surgical complications. Result At the last follow-up, all patients' VA improved compared to before surgery, with an average improvement of (3.7±2.2) lines on the standard VA chart. 16/18 eyes maintained 7~21 mmHg without the use of IOP lowering drugs and 2/18 eyes maintained normal IOP 6 months after surgery with the addition of a local IOP lowering drug. After the improved pars plana vitreous drainage, all patients had a decrease in IOP during surgery, and the ACD deepened compared to before drainage. No serious complications occurred during or after the surgery in all patients. Conclusion The improved pars plana vitreous drainage is a safe and effective method for the combined surgery of glaucoma and cataract in the treatment of angle closure glaucoma with abnormal lens suspensory ligament. (Ophthalmol CHN, 2023, 32: 403-408)

Key words: glaucoma/surgery, lens suspensory ligament, pars plana vitreous drainage