Primary Outcomes of Patients with Chronic Angle-closure Glaucoma Treated with Combined Phacoemulsification, Viscogoniosynechialysis and Endocyclophotocoagulation.

Abstract

Purpose : To evaluate the effectiveness of combined Phacoemulsification, viscogoniosynechialysis (VGSL) and endocyclophotocoagulation (ECP) in patients with moderate chronic angle-closure glaucoma (CACG) with peripheral anterior synechia (PAS) ≥90 not controlled with glaucoma medications and previous iridotomy yag laser.

Methods : Retrospectively reviewed records from patients with cataract, uncontrolled chronic angle-closure glaucoma despite maximal tolerated medical therapy and iridotomy yag laser who received combined treatment with phacoemulsification with posterior capsular lens implantation, VGSL and ECP 360°. It was evaluated the intraocular pressure (IOP), glaucoma medications, best corrected visual acuity (BCVA) preoperatively and during follow-up.

Results : A total of 29 eyes from 22 patients received surgical intervention. Mean follow up was 6 months. Mean preoperative IOP was 18.2 mmHg and postoperatively were 13.5, 12.2, 12.8 mmHg at 1, 3 and 6 months respectively. Complete success was 37.9% and relative success was 72.4%. Mean BCVA was 0.4 logMAR preoperative and 0.3 logMAR 6 months after surgery. Glaucoma medication fell significantly from 2.34±1.66 preoperatively to 1.31±2.6 postoperatively (p<0.001), Overall 44.8% of the patients did not require glaucoma medications at 6 months. There were no visual significant complications.

Conclusions : Combined treatment with phacoemulsification with posterior capsular lens implantation, VGSL and ECP is effective and safe in reducing IOP and number of glaucoma medications with stable BCVA at 6 months.

This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.