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Guoping Qing, Dapeng Mou; Efficacy of Goniosynechialysis for Chronic Angle-Closure Glaucoma. Invest. Ophthalmol. Vis. Sci. 2013;54(15):4784. doi: https://doi.org/.
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To evaluate the intraocular pressure (IOP) lowering efficacy of goniosynechialysis (GSL) for chronic angle-closure glaucoma (CACG) using a simplified slit lamp technique.
Patients with CACG was treated randomly with either anterior chamber(AC) paracentesis-guided limited GSL under biomicroscope with a needle or anti-glaucoma medication after laser peripheral iridotomy (LPI). All patients underwent ophthalmologic examinations including measurement of VA, BCVA, and IOP, biomicroscopy; fundus examination; and gonioscopy followed by GSL in the surgery group and prescription of anti-glaucoma medication in the control group.
Forty-four patients (28 men, 14 women) were identified as having CACG with an initial mean IOP of 27.1 ± 6.7 mmHg (range, 25-37) in the surgery group and 26.8± 7.4mmHg (range, 23-41) in the control group. No statistical difference was identified between the average initial IOP of the two groups. Six month after the treatment, the mean IOP in the surgery group decreased to 16.3 ± 2.8 mmHg (range, 14-19) without antiglaucoma medication. Meanwhile, the average IOP in the control group was 17.3 ± 2.4 mmHg (range, 13-20) without an average of 1.4 antiglaucoma eydrops (range, 1-3). Both groups have a significant decrease in IOP after the treatment. Nevertheless, the surgery group had statistically lower IOP and more decrease in IOP than that of the control group, identified with paired sample T test. AC bleeding was the most common complication of the AC paracentesis guided GSL, which occurred in 59.1% of the cases(13 /22) and was absorbed thin several days without special care. No visual field deterioration or visual impairment was discerned in both groups.
The novel slit lamp procedure, AC paracentesis guided limited GSL lowers the IOP in patients with CACG, though it may lead to mild AC bleeding.
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