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Abstract #25308 Published in IGR 12-1
Combined phacoemulsification and viscogoniosynechialysis in the management of patients with chronic angle closure glaucoma
Razeghinejad M R; Rahat FInternational Ophthalmology 2010; 1-7
The purpose of this study was to evaluate the effectiveness of phacoemulsification and viscogoniosynechialysis in the management of patients with chronic angle-closure glaucoma (CACG). Fifty-six eyes of 45 recruited patients were classified into two groups: group 1 had medically controlled CACG (IOP (less-than or equal to) 21 mmHg) comprising 35 eyes and group 2 medically uncontrolled CACG (IOP > 21 mmHg with maximum tolerated medications) including 21 eyes. All of the patients had at least one quadrant without peripheral anterior synechia in gonioscopy. After phacoemulsification, a viscoelastic agent was used for viscogoniasynecialysis. Success was defined as IOP (less-than or equal to) 21 mmHg with (relative success) or without (absolute success) medications. There were no statistically significant differences between the two groups regarding age and gender. In group 1, the mean IOP and number of medications declined from 16.7 (plus or minus) 2.9 to 14.4 (plus or minus) 2.9 (P < 0.0001) and 2.6 (plus or minus) 0.8 to 0.82 (plus or minus) 0.82 (P < 0.0001), respectively. The absolute success rate at the last follow-up (9 (plus or minus) 5.3 months) was 40%. In group 2, the mean IOP and number of medications diminished from 27.95 (plus or minus) 8.1 to 15.5 (plus or minus) 2.8 (P < 0.0001) and 2.9 (plus or minus) 0.62 to 1.2 (plus or minus) 1.2 (P < 0.0001), respectively. The absolute success rate was 38.1% at the last follow-up (9.5 (plus or minus) 5.3 months). Postoperatively, seven patients developed pupillary fibrin formation that was treated using steroids and ND: YAG laser. In the other two patients, the medically unresponsive cystoid macular edema was treated successfully by intravitreal Bevacizumab. Combined phacoemulsification and viscogoniosynechialysis seem to be an effective surgical procedure in the treatment of patients with CACG and angle restoration whether controlled or uncontrolled by medication.
M.R. Razeghinejad. Poostchi Ophthalmology Research Centre, Khalili Hospital, Shiraz University of Medical Sciences, Shiraz, Iran. aflareza@gmail.com
Classification:
12.14.3 Phacoemulsification (Part of: 12 Surgical treatment > 12.14 Combined cataract extraction and glaucoma surgery)