Abstract
This research was designed to evaluate the efficacy and safety of ab-interno trabeculectomy (Trabectome and Kahook Dual Blade) combined with phacoemulsification, intraocular lens implantation, and goniosynechialysis in eyes with primary angle-closure glaucoma. A total of 51 patients were included in the study and all the patients received the combined surgery. Intraocular pressure, anti-glaucoma medications, best-corrected visual acuity, and the number of peripheral anterior synechiae quadrants were recorded at baseline and at various time points after surgery. Intraocular pressure decreased significantly from 21.19 ± 6.38 mmHg preoperatively to 16.00 ± 4.84 mmHg (P = 0.01) at 36 months. The number of glaucoma medications was significantly reduced from 2.33 ± 1.29 preoperatively to 1.42 ± 1.78 (P = 0.045) at 36 months. The success rate of the combined surgery was 87.5% at 36 months. The decrease of intraocular pressure exhibited a positive correlation with the baseline intraocular pressure (P < 0.01), while the reduction in the number of glaucoma medications was positively correlated with the baseline number of glaucoma medications (P < 0.001). Best-corrected visual acuity improved from 0.40 ± 0.29 to 0.50 ± 0.33 at 1 month (P = 0.001). There were no vision‑threatening complications intraoperatively or postoperatively. The combined surgery has been proven to be effective and safe for patients with primary angle-closure glaucoma in the long term, suggesting that combined surgery may be beneficial for patients with primary angle-closure glaucoma, especially those with long-term and extensive peripheral anterior synechiae.