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Abstract #51231 Published in IGR 14-3
Effect of adjunctive viscogonioplasty on drainage angle status in cataract surgery: a randomized clinical trial
Eslami Y; Latifi G; Moghimi S; Ghaffari R; Fakhraie G; Zarei R; Jabbarvand M; Mohammadi M; Lin SClinical and Experimental Ophthalmology 2013; 41: 368-378
BACKGROUND: To compare the anatomic effects of phacoemulsification(Phaco) versus combined phacoemulsification and viscogonioplasty(Phaco-VGP) on drainage angle status in primary angle closure glaucoma(PACG) using anterior segment optical coherence tomography(AS-OCT). DESIGN: Prospective, randomized clinical trial PARTICIPANTS: Sixty-seven eyes of 57 patients with the diagnosis of PACG METHOD: Patients were randomized to undergo Phaco alone(33 eyes) or Phaco-VGP(34 eyes). Patients were examined post-operatively on day 1, week 1, and week 6. Indentation gonioscopy and AS-OCT were performed preoperatively and at 6 weeks after surgery. MAIN OUTCOME MEASURES: Angle and anterior segment parameters by AS-OCT and amount of peripheral anterior synechiae(PAS) by gonioscopy. RESULTS: Sixty-five eyes of 55 patients completed the trial. The mean extent of PAS was significantly reduced from 127.7 to 95.0 degrees(P<0.001) by Phaco alone, and from 174.0 to 77.3 degrees(P<0.001) by Phaco-VGP. Phaco-VGP resulted in significantly greater reduction in PAS extent(P=0.002). Angle opening distance and trabecular-iris space-area measured by AS-OCT increased significantly after Phaco alone and Phaco-VGP (P<0.001 for both). Although the change was higher in the Phaco-VGP group, this did not reach statistically significance. Anterior chamber depth(ACD) increased and lens vault(LV) decreased after both procedures. The amount of change in ACD and LV was not significant between the 2 groups. CONCLUSION: Both Phaco alone and Phaco-VGP resulted in widening of the drainage angle, deepening of the anterior chamber, and reduction of IOP and PAS extent in PACG eyes. Phaco-VGP resulted in significantly more reduction of PAS. However, it seems that additional VGP has no significant effect on short-term IOP.
Farabi Eye Research Center, Tehran University of Medical Science, Tehran, Iran.
Full articleClassification:
12.12.3 Phacoemulsification (Part of: 12 Surgical treatment > 12.12 Cataract extraction)
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)