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Abstract #50605 Published in IGR 14-2
Long-term efficacy of goniosynechialysis combined with phacoemulsification for primary angle closure
Kameda T; Inoue T; Inatani M; Tanihara H;Graefe's Archive for Clinical and Experimental Ophthalmology 2013; 251: 825-830
AIMS: To evaluate long-term efficacy of goniosynechialysis (GSL) combined with phacoemulsification and intraocular lens implantation (phaco-GSL) for primary angle closure or primary angle-closure glaucoma (PAC/PACG) and to analyze risk factors for surgical outcomes. METHODS: We reviewed medical records of 109 eyes of 109 patients (mean [± SD] age 70 ± 9.4 years) who underwent phaco-GSL as primary treatment of PAC/PACG at five institutions. All eyes had a preoperative intraocular pressure (IOP) of ≥21 mmHg with or without medications. Surgical failure was defined as: (1) condition A: persistent IOP values of ≥21 mmHg, or (2) condition B: IOP values of ≥18 mmHg, with or without topical ocular medication, at two consecutive follow-up visits, or additional operations needed. Risk factors for surgical failure were analyzed via Cox proportional hazards model. RESULTS: Mean follow-up was 40.0 months (range, 1 to 139 months). Probabilities of treatment success at 1 and 3 years after phaco-GSL were 85.9 % and 85.9 % (condition A) and 66.2 % and 61.0 % (condition B) respectively. Via multivariable analysis, we identified risk factors for surgical failure to be younger age (relative risk [RR] = 0.93/year, P = 0.0333) and absence of postoperative laser peripheral iridoplasty (LPI) (P = 0.0359) for condition A, and younger age (RR = 0.94/year, P = 0.0035), lower preoperative IOP (RR = 0.93/mm Hg, P = 0.0131), and absence of postoperative LPI (RR = 2.34, P = 0.0228) for condition B. CONCLUSIONS: The outcome of phaco-GSL for PAC/PACG may depend on age, preoperative IOP, and postoperative LPI.
Department of Ophthalmology and Visual Science, Graduate School of Medical Sciences, Kumamoto University, 1-1-1 Honjo, Kumamoto, Japan.
Full articleClassification:
12.14.3 Phacoemulsification (Part of: 12 Surgical treatment > 12.14 Combined cataract extraction and glaucoma surgery)
12.9 Trabeculotomy, goniotomy (Part of: 12 Surgical treatment)
9.3.5 Primary angle closure (Part of: 9 Clinical forms of glaucomas > 9.3 Primary angle closure glaucomas)