Two-year outcome of phacogoniotomy for advanced primary angle-closure glaucoma with cataracts: a multicentre study.
Song Yunhe, Xie Lin, Zhu Xiaomin, Fan Sujie, Lv Aiguo, Tang Guangxian, Zhang Hengli, Tang Li, Zhang Yao, Lu Lan
AI Summary
This study found combined cataract surgery and angle procedures effectively lowered IOP and medication use for advanced angle-closure glaucoma over two years, offering a safe treatment option.
Abstract
Purpose
To report the 2-year effective and safety profile of integrated phacoemulsification with intraocular lens implantation (PEI), goniosynechialysis (GSL) and 120° goniotomy (GT) in advanced primary angle-closure glaucoma (PACG) and cataracts.
Design
Multicentre prospective study.
Methods
201 eyes of 196 patients who received combined PEI+GSL+ GT were assessed at baseline and re-evaluated at days 1, 7, and at 1, 3, 6, 12 and 24 months postsurgery. The intraocular pressure (IOP), the number of topical hypotensive medications, surgical complications and achievements of surgery success were also evaluated.
Results
All participants were followed up for a 2-year period. The average IOP declined from 33.0±10.7 mm Hg to 13.6±2.9 mm Hg, and the number of topical hypotensive medication decreased from an average of 2.4 types to 0.4 at month 24. For the safety profile, the major complications were hyphema (n=14, 7.0%), IOP spike (n=9, 4.9%) and transit corneal oedema (n=23, 11.4%). The complete success was achieved in 72.6% of the eyes (146 out of 201), and the qualified success rate was 91.5% (184 out of 201). Only one eye required tube shunt surgery while no one developed severe vision-threatening complications. The best-corrected visual acuity increased from 0.80±1.08 to 0.54±0.78 LogMAR.
Conclusions
PEI+GSL+GT is shown to be effective and safe in treating advanced PACG with cataract over a 2-year follow-up period. The combined surgery may be considered as an alternative for patients with advanced PACG.
MeSH Terms
Shields Classification
Key Concepts5
Integrated phacoemulsification with intraocular lens implantation (PEI), goniosynechialysis (GSL), and 120° goniotomy (GT) in advanced primary angle-closure glaucoma (PACG) with cataracts reduced the average intraocular pressure (IOP) from 33.0±10.7 mm Hg to 13.6±2.9 mm Hg over a 2-year follow-up period.
Integrated phacoemulsification with intraocular lens implantation (PEI), goniosynechialysis (GSL), and 120° goniotomy (GT) in advanced primary angle-closure glaucoma (PACG) with cataracts decreased the number of topical hypotensive medications from an average of 2.4 types to 0.4 at month 24.
Integrated phacoemulsification with intraocular lens implantation (PEI), goniosynechialysis (GSL), and 120° goniotomy (GT) in advanced primary angle-closure glaucoma (PACG) with cataracts achieved a complete success rate of 72.6% (146 out of 201 eyes) and a qualified success rate of 91.5% (184 out of 201 eyes) over a 2-year follow-up period.
Integrated phacoemulsification with intraocular lens implantation (PEI), goniosynechialysis (GSL), and 120° goniotomy (GT) in advanced primary angle-closure glaucoma (PACG) with cataracts improved best-corrected visual acuity (BCVA) from 0.80±1.08 to 0.54±0.78 LogMAR over a 2-year follow-up period.
Major complications of integrated phacoemulsification with intraocular lens implantation (PEI), goniosynechialysis (GSL), and 120° goniotomy (GT) in advanced primary angle-closure glaucoma (PACG) with cataracts included hyphema (n=14, 7.0%), IOP spike (n=9, 4.9%), and transient corneal oedema (n=23, 11.4%) over a 2-year follow-up period.
Related Articles5
One-Year Results of a Multicenter Study: Intraocular Pressure-Lowering Effect of Combined Phacoemulsification, Goniosynechialysis, and Goniotomy for Cases of Advanced Primary Angle-Closure Glaucoma With Cataract.
Observational StudyAngle, anterior chamber parameters, and intraocular pressure changes after early phacoemulsification in acute angle-closure glaucoma.
Case SeriesPhacogoniotomy: An alternative treatment for advanced primary angle-closure glaucoma with cataract.
Case SeriesEfficacy of Combined Phacoemulsification and Goniosynechialysis in Primary Angle Closure Disease With Different Degrees of Peripheral Anterior Synechiae.
Retrospective StudySafety and efficacy of incisional goniotomy as an adjunct with phacoemulsification in primary angle-closure glaucoma.
Case SeriesIs this article assigned to the wrong chapter(s)? Let us know.