Objective    To observe the changes of chamber angle after phacoemulsification and goniosynechialysis (Phaco-GSL) for primary angle-closure glaucoma (PACG) with cataract

and evaluate the therapeutic effect of Phaco-GSL on PACG.     Methods    Fifty patients (50 eyes) with PACG and cataract were treated in our hospital

and peripheral anterior synechiae (PAS) of all their affected eyes was over 180 degrees. By single blind method

they were randomly divided into Phaco-GSL treated group (treatment group) and single phacoemulsification group (control group). The chamber angles were checked with gonioscopy 1 and 3 months after operation

and intraocular pressure (IOP) of 50 eyes was examined 1 week

1 and 3 months after operation.     Results    ①In group A

the rate that chamber angles reopened were over 180 degrees was 100%

and the chamber angles were wide

trabecular meshwork visible in 5 cases (20%)

scleral spur visible in 12 cases (48%) and ciliary band visible in 8 cases (32%). In group B

the chamber angles reopened over 180 degrees were in 12 cases (48%) 1 month after operation and PAS reoccurred in 2 affected eyes. The effect of reopening chamber angle in group A was better than that in group B (P0.05). The degree of pigmentation decreased gradually over time in reopened eyes after operation; ②IOP was 25-58 mmHg (average 28.67) before operation. After operation 23 eyes (92%) in group A and 9 eyes (18.37%) in group B acquired normal IOP without using anti-glaucoma drugs

with significant difference between the 2 groups (P0.01).     Conclusion    Phaco-GSL can reopen chamber angles for the patients with PACG and cataract

and position of iris insertion

and angle of anterior chamber and iris shape are stable in reopened angles. PACG and cataract patients with PAS 180 degrees can be treated by cataract extraction combined with goniosynechialysis

while trabeculectomy is not necessary.