Impact of Peripheral Anterior Synechiae on the Outcome of Combined Phacoemulsification, Goniosynechialysis, and Goniotomy for Primary Angle Closure Glaucoma and Cataract: A Multicenter Observational Study-Reference-Cited by-同舟云学术

Impact of Peripheral Anterior Synechiae on the Outcome of Combined Phacoemulsification, Goniosynechialysis, and Goniotomy for Primary Angle Closure Glaucoma and Cataract: A Multicenter Observational Study

Published:2024-05-21 Issue:8 Volume:33 Page:587-593
ISSN:1057-0829
Container-title:Journal of Glaucoma
language:en
Short-container-title:

Author:

Lin Fengbin¹,Zhang Yingzhe¹,Zhu Xiaomin²,Yu Ping³,Fan Sujie⁴,Lv Aiguo⁴,Li Xiaoyan⁴,Tang Li⁵,Zhang Yao⁵,Tang Guangxian⁶,Yan Xiaowei⁶,Lu Lan⁷,Xiao Meichun⁷,Yuan Huiping⁸,Song Wulian⁸,Zhou Minwen⁹,Zhao Xiaohuan⁹,Nie Xin¹⁰,Liao Mengfei¹⁰,Song Yunhe¹,Wang Zhenyu¹,Chen Weirong¹,Barton Keith¹¹,Park Ki Ho¹²,Aung Tin¹³,Lam Dennis S.C.¹⁴,Weinreb Robert N.¹⁵,Tham Clement C.¹⁶,Zeng Liuzhi³,Xie Lin²,Wang Ningli¹⁷,Zhang Xiulan¹,

Affiliation:

1. Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou

2. Department of Ophthalmology, The Third Affiliated Hospital of Chongqing Medical University, Chongqing

3. Department of Ophthalmology, Chengdu First People’s Hospital, Chengdu

4. Handan City Eye Hospital (The Third Hospital of Handan), Handan

5. Department of Ophthalmology, West China Hospital of Sichuan University, Chengdu

6. Department of Ophthalmology, Shijiazhuang People’s Hospital, Shijiazhuang

7. Department of Ophthalmology, Fujian Medical University Union Hospital, Fuzhou, Fujian Province

8. Department of Ophthalmology, The 2nd Affiliated Hospital, Harbin Medical University, Harbin

9. Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University, Shanghai

10. Department of Ophthalmology, Chongqing People’s Hospital, Chongqing

11. NIHR Biomedical Research Centre, Moorfields Eye Hospital NHS Foundation Trust, UCL Institute of Ophthalmology, London, United Kingdom

12. Department of Ophthalmology, Seoul National University College of Medicine, Seoul, Korea

13. Singapore National Eye Centre, Singapore Eye Research Institute, Singapore, Singapore

14. The International Eye Research Institute, The Chinese University of Hong Kong (Shenzhen), Shenzhen, China

15. Hamilton Glaucoma Center, Viterbi Family Department of Ophthalmology, Shiley Eye Institute, University of California, San Diego, CA

16. Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong Special Administrative Region

17. Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing, China

Abstract

Précis: The combination of phacoemulsification, goniosynechialysis and goniotomy is an effective treatment for primary angle closure glaucoma patients with cataract, and this is not linked to the extent of preoperative peripheral anterior synechiae. Purpose: To evaluate the impact of the extent of peripheral anterior synechiae (PAS) on the effectiveness and safety of combined phacoemulsification (PEI), goniosynechialysis (GSL), and goniotomy (GT) in eyes with primary angle closure glaucoma (PACG) and cataract. Patients and Methods: This study included patients diagnosed with PACG and cataracts who underwent combined PEI and 120 degrees GSL plus GT (PEI+GSL+GT) between April 2020 and October 2022 at 10 ophthalmic institutes. Eligible patients were divided into 3 groups based on the extent of PAS: 180°≤PAS<270°, 270°≤PAS<360°, and PAS=360°. Data on intraocular pressure (IOP), the number of ocular hypotensive medications, and complications were collected and compared. The study defined complete success as postoperative IOP within the 6–18 mm Hg range and a 20% reduction from baseline without the use of topical medications. Qualified success was defined in the same way as complete success, but it allowed for the use of ocular hypotensive medications. Results: Three hundred four eyes of 283 patients were included. The mean follow-up was 12.50±1.24 months. All groups experienced a significant reduction in IOP after the surgery (P<0.05). There were no significant differences in final IOP, number of medications, and cumulative complete and qualified success rates among the 3 groups (P>0.05). The groups with 270°≤PAS<360°had a higher frequency of hyphema compared with 180°≤PAS<270° (P = 0.044). Conclusions: PEI+GSL+GT has proven to be an effective treatment for PACG with cataracts over a 1 year period. However, the outcome was not correlated with the preoperative extent of PAS.

Publisher

Ovid Technologies (Wolters Kluwer Health)

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