advertisement
Abstract #12439 Published in IGR 7-2
Phacoemulsification and goniosynechialysis in the management of unresponsive primary angle closure
Harasymowycz PJ; Papamatheakis DG; Ahmed I; Assalian A; Lesk M; Al-Zafiri Y; Kranemann C; Hutnik CJournal of Glaucoma 2005; 14: 186-189
PURPOSE: To evaluate the effectiveness of phacoemulsification and goniosynechialysis (PEGS) in managing acute and subacute primary angle closure unresponsive to conventional therapy. MATERIALS AND METHODS: Retrospective series of patients of six glaucoma-trained surgeons with primary angle closure that did not respond to medical management, Nd:YAG laser peripheral iridotomy, or argon laser peripheral iridoplasty. RESULTS: A total of twenty-one patients with an average age of 65.6 years were included. Underlying mechanism of angle closure included pupillary block (n = 18) and plateau iris (n = 3). Average intraocular pressure (IOP) immediately prior to PEGS was 40.7 mmHg, and mean follow-up time after PEGS was 11.7 months. PEGS decreased mean IOP by 25 mmHg (62%), and mean number of medications from 3.8 pre-surgery to 1.7 post-surgery (55%). Mean LogMar visual acuity improved after PEGS, from 0.64 to 0.44 (Paired t test t = 4.120 P = 0.001). Subsequent trabeculectomy was necessary in one case (5%). CONCLUSIONS: Phacoemulsification with goniosynechialysis may be an effective treatment option for primary angle closure unresponsive to conventional therapy.
Dr. P.J. Harasymowycz, Department of Ophthalmology, Universite de Montreal, Montreal, Quebec, Canada. pharasymowycz@sympatico.ca
Classification:
9.3.2 Chronic primary angle closure glaucoma (pupillary block) (Part of: 9 Clinical forms of glaucomas > 9.3 Primary angle closure glaucomas)
12.12.3 Phacoemulsification (Part of: 12 Surgical treatment > 12.12 Cataract extraction)
