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Outcomes of effective goniosynechialysis under an endoscopic view combined with phacoemulsification in residual angle-closure glaucoma with lens opacity: 6-month results

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Abstract

Purpose

We aimed to evaluate the efficacy and safety of effective goniosynechialysis (GSL) under an endoscopic view combined with phacoemulsification in residual angle-closure glaucoma with lens opacity.

Methods

This was a retrospective study. Patients with residual angle-closure glaucoma, lens opacity, and uncontrolled intraocular pressure (IOP) who were receiving anti-glaucoma medications were selected to undergo effective GSL under an endoscopic view combined with phacoemulsification. Follow-up examinations were conducted until 6 months postoperatively.

Results

Twenty-five eyes of 24 patients diagnosed with residual angle-closure glaucoma and lens opacity and peripheral anterior synechiae (PAS) at least ≥ 270° were included. Their mean age was 61.32 ± 6.11 years. Preoperatively, the mean (standard error) IOP was 29.69 (11.22) mmHg, and the median number of IOP-lowering medications used was 3.0. The decreases in the rates of IOP of the patients were 44.29%, 52.17%, 46.95%, 48.37%, and 47.29% at 1 day, 1 week, 1 month, 2.5 months, and 6 months after the surgery, respectively. At 6 months, the median number of IOP-lowering medications used decreased from 3 to 0 and the range of PAS compared to the baseline decreased from 312° to 107° (P < 0.001). We also found that 21/25 eyes achieved improved or stable visual acuity after surgery. Postoperative complications included transiently elevated IOP (12.0%), exudation (8.0%), and hyphema (4.0%).

Conclusions

Phacoemulsification combined with effective GSL under an endoscopic view may reopen residual angle-closure glaucoma and reduce the number of IOP-lowering medications for up to 6 months. It is an effective and safe method for patients with residual angle-closure glaucoma and lens opacity.

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Acknowledgements

This study was supported by Youth Project of Wuxi Municipal Health Commission (no. Q201805). We would like to thank Editage (www.editage.cn) for English language editing.

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Author notes

  1. W. Tang and Z. Zhang have contributed equally to this work.

Authors and Affiliations

  1. Department of Ophthalmology, Wuxi NO.2 People’s Hospital Affiliated to Nanjing Medical University, Zhongshan Road 68, Wuxi, 214002, Jiangsu, People’s Republic of China

    Wei Tang, Zhengwei Zhang, Xiaolei Yin & Yinong Zhang

  2. Physiology of Nanjing Medical University, Tian yuan East Road 818, Nanjing, 211166, Jiangsu, People’s Republic of China

    Yujie Zhang

  3. Department of Intensive Care Unit, Wuxi NO.2 People’s Hospital Affiliated to Nanjing Medical University, Zhongshan Road 68, Wuxi, 214002, Jiangsu, People’s Republic of China

    Qianqian Li

Authors
  1. Wei Tang
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  2. Zhengwei Zhang
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  3. Yujie Zhang
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  4. Xiaolei Yin
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  5. Yinong Zhang
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Correspondence to Yinong Zhang or Qianqian Li.

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This study has no commercial or propriety interest. The authors report no conflict of interest.

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Tang, W., Zhang, Z., Zhang, Y. et al. Outcomes of effective goniosynechialysis under an endoscopic view combined with phacoemulsification in residual angle-closure glaucoma with lens opacity: 6-month results. Int Ophthalmol 40, 3529–3538 (2020). https://doi.org/10.1007/s10792-020-01541-y

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  • DOI: https://doi.org/10.1007/s10792-020-01541-y

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