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Abstract #53578 Published in IGR 15-2
Outcomes of combined lens extraction and goniosynechialysis in angle closure
White AJ; Orros JM; Healey PRClinical and Experimental Ophthalmology 2013; 41: 746-752
BACKGROUND: The aim of this study was to assess the effect of goniosynechialysis on intraocular pressure (IOP) and glaucoma medication requirement in patients with angle closure DESIGN: A retrospective chart review PARTICIPANTS: 51 eyes from 42 patients were included in the study. 17 had documented evidence of acute angle closure while 34 had chronic angle closure. METHODS: Examination of the medical records of consecutive patients with synechial primary angle closure who underwent combined phacoemulsification and goniosynechialysis from 2003- 2011 at 3 centres. MAIN OUTCOME MEASURES: IOP and requirement for IOP lowering drops were the main outcome measures RESULTS: Mean follow-up was 25.9 months for the acute group and 25.4 months for the chronic group. Mean preoperative IOP was 23.3 ± 14.4mmHg on an average of 2.5 ± 1.3 glaucoma medications. Mean postoperative IOP was lowered to 13.7 ± 2.4 (p=<0.01) and medication usage was significantly lowered to 0.6 ± 0.9 (p=<0.01). Subjects with documented acute symptomatic angle closure had higher preoperative IOP and a larger IOP fall post GSL (from 30.4mmHg ± 23mmHg to 12.1mmHg ± 2.3mmHg ) compared to those without such a documented episode (19.8 mmHg ± 4.4mmHg to 14.4mmHg ± 2.1mmHg, p=0.007). Both groups have similar post op need for glaucoma medication, 0.7± 0.9 vs 0.7 ± 0.9. CONCLUSIONS: Combined phacoemulsification and goniosynechialysis reduces IOP, medication requirements and need for further surgery in subjects with angle closure. The procedure is more effective in eyes with a previously documented acute symptomatic presentation of angle closure.
Centre for Vision Research, Department of Ophthalmology and Westmead Millenium Institute, University of Sydney, NSW, Australia.
Full articleClassification:
9.3.5 Primary angle closure (Part of: 9 Clinical forms of glaucomas > 9.3 Primary angle closure glaucomas)
12.14.3 Phacoemulsification (Part of: 12 Surgical treatment > 12.14 Combined cataract extraction and glaucoma surgery)
