Efficacy of Combined Phacoemulsification and Goniosynechialysis in Primary Angle Closure Disease With Different Degrees of Peripheral Anterior Synechiae. Issue 7 (10th July 2022)

• Record Type: Journal Article
• Authors: Wei, Liqing; Fu, Lin; Nie, Li; Lian, Hengli; Qian, Zhenbin; Liang, Yuanbo; Pan, Weihua
• Is Part Of: Journal of glaucoma. Volume 31:Issue 7(2022)
• Page Start: 540
• Page End: 546
• Publication Date: 2022-07-10
• Subjects: primary angle-closure glaucoma -- goniosynechialysis -- PAS -- mechanical separation -- recurrence of PAS; Glaucoma -- Periodicals; 617.741005
• DOI: 10.1097/IJG.0000000000002050
• Languages: English
• ISSNs: 1057-0829

Abstract

Abstract : Précis: Phacoemulsification and goniosynechialysis (Phaco-GSL) was equally effective in the treatment of primary angle-closure disease (PACD) with preoperative peripheral anterior synechiae (PAS) <180 degrees and larger than 180 degrees. Patients with a larger preoperative PAS range required more range of mechanical separation intraoperatively and displayed more recurrence of PAS (re-PAS) range postoperatively. Purpose: To evaluate the long-term efficacy of combined phaco-GSL in PACD with different extent of PAS. Patients and Methods: A retrospective study was conducted on 67 patients (79 eyes) who received phaco-GSL. The patients were divided into 2 groups according to the extent of PAS (group A: PAS ≤180 degrees; group B: PAS >180 degrees). Changes in intraocular pressure (IOP), the number of anti-glaucoma drugs, intraoperative mechanical separation of PAS and range of re-PAS during the last follow-up ≥12 months were analyzed. Results: At baseline, eyes in group B presented with higher IOP and more anti-glaucoma drugs usage ( P =0.008 and 0.004). The PAS range, IOP, number of anti-glaucoma medication were reduced both in 2 groups at the final visit. The range of mechanical separation intraoperatively and re-PAS postoperatively were both larger in group B ( P =0.002 and <0.001). The postoperative re-PAS range was positively correlated with the range of mechanical separation ( R 2 =0.17). The complete success rates at 12, 24, 36, and 48 months were 86.8%, 71.1%, 71.1%, and 71.1% in group A; and 80.5%, 74.6%, 69.9%, and 69.9% in group B. The qualified success rates were 100%, 96.6%, 92.0%, and 92.0% in group A; and 100%, 89.5%, 85.1%, and 85.1% in group B. Conclusion: Phaco-GSL for the treatment of PACD showed equally effective IOP control regardless of the extent of preoperative PAS.