J Glaucoma
J GlaucomaAugust 2025Multicenter Study

Outcomes of Phacogoniotomy for Medically Controlled and Uncontrolled Primary Open Angle Glaucoma With Cataract: A Multicenter Study.

IOP & Medical TherapyGlaucoma Surgery

Summary

POAG with cataract could be effectively treated by phacogoniotomy, regardless of medically controlled or medically uncontrolled status at baseline.

Abstract

PRCIS

Phacogoniotomy, a combination of phacoemulsification and intraocular lens implantation (PEI) and 120-degree goniotomy (GT), was an effective and safe surgical treatment for medically controlled or uncontrolled primary open angle glaucoma (POAG) with cataract.

PURPOSE

To evaluate the efficacy and safety of PEI combined with 120-degree GT in the treatment of medically controlled or uncontrolled POAG with cataract.

METHODS

Multicenter observational study conducted in 9 ophthalmic institutes/general hospitals in China. Patients with medically controlled [baseline intraocular pressure (IOP) ≤21 mmHg] or uncontrolled (baseline IOP > 21 mmHg) POAG with clinically significant cataract were included, who were followed up with at least 12 months. The IOP, topical hypotensive medication, surgery complications, visual acuity, surgery success were recorded and compared between groups at baseline and the final visit. Complete surgical success was defined as postoperative IOP of 5-18 mmHg without additional topical medications, vision-threatening complications or reoperation for glaucoma. Qualified success is same as complete success except allowing use of ocular hypotensive medications.

RESULTS

One hundred participants with 132 eyes were included with a mean follow-up time of 17.5±5.2 months ( range:12-32) postoperatively. In general, the mean IOP reduced from 21.2±7.4 mmHg at baseline to 14.7±2.9 mmHg postoperatively ( P 0.05), respectively.

CONCLUSION

POAG with cataract could be effectively treated by phacogoniotomy, regardless of medically controlled or medically uncontrolled status at baseline.

Keywords

goniotomyminimally invasive glaucoma surgeryphacoemulsificationprimary open angle glaucoma

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