June 2022
Volume 63, Issue 7
Open Access
ARVO Annual Meeting Abstract  |   June 2022
Clinical assessment of the effectiveness of phacoemulsification associated with goniosynechialysis in angle closure treatment
Author Affiliations & Notes
  • Nuria Guardia Ruiz
    Ophthalmology, Hospital Clinico Universitario de Valladolid, Valladolid, Castilla y León, Spain
  • Yolanda Diebold
    Instituto de Oftalmobiologia Aplicada, Valladolid, Castilla y León, Spain
    Bioingeniería, Biomateriales y Nanomedicina, Centro de Investigacion Biomedica en Red, Madrid, Comunidad de Madrid, Spain
  • José Ramón Juberías
    Ophthalmology, Hospital Clinico Universitario de Valladolid, Valladolid, Castilla y León, Spain
    Instituto de Oftalmobiologia Aplicada, Valladolid, Castilla y León, Spain
  • Footnotes
    Commercial Relationships   Nuria Guardia Ruiz None; Yolanda Diebold None; José Ramón Juberías None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science June 2022, Vol.63, 3680 – A0365. doi:
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      Nuria Guardia Ruiz, Yolanda Diebold, José Ramón Juberías; Clinical assessment of the effectiveness of phacoemulsification associated with goniosynechialysis in angle closure treatment. Invest. Ophthalmol. Vis. Sci. 2022;63(7):3680 – A0365.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : To identify whether there is a decrease in intraocular pressure (IOP) values and the number of hypotensive active principles (AP) required in patients diagnosed with suspected angle closure (SAC), angle closure (AC), and angle closure glaucoma (ACG) who underwent phacoemulsification surgery with intraocular lens (IOL) implantation and goniosynechialysis.

Methods : Retrospective observational study of patients diagnosed of SAC, AC or ACG who received phacoemulsification with IOL implantation and goniosynechialysis by the same glaucoma surgeon in the last 10 years at the Glaucoma Units of the Valladolid Clinic Hospital and the Institute of Applied OphthalmoBiology (University of Valladolid, Valladolid, Spain). We evaluated the difference between baseline and pre-surgical IOP compared to IOP at different times of postoperative follow-up (1, 3 and 12 months), and the difference between numbers of hypotensive AP administered before and after surgery at the same follow-up months.

Results : We analyzed 64 eyes, 31 with AC, 26 with ACG, and 7 with SAC. A statistically significant decrease between baseline and pre-surgical IOP and IOP assessed 1, 3 and 12 months after surgery in AC and ACG patients was observed (p<0.001). AC patients showed a 43.6% decrease between baseline and pre-surgical IOP, a 51.3 to 56.6% decrease between baseline and post-surgical IOP, and a 13.3 to 22.9% decrease between pre-surgical and post-surgical IOP. ACG patients showed a 41.5% decrease in pre-surgical IOP compared to baseline IOP, a 53.2 to 56.5% decrease in post-surgical IOP compared to baseline IOP, and a 19.7 to 25.7% decrease in post-surgical IOP compared to pre-surgical IOP. SAC patients showed a 9.47 to 11.74% decrease in postsurgical IOP compared to pre-surgical IOP (p<0.05). Regarding numbers of administered AP, we observed a statistically significant decrease in AP at 1, 3, and 12 months after surgery compared to prior to surgery in both AC (53.4 to 61.5%) (p<0.001) and ACG (41.9 to 54.5%) (p<0.05) patients. In SAC patients, no differences were observed.

Conclusions : Phacoemulsification surgery with IOL implantation, together with goniosinechialysis, significantly lowers the IOP and the AP number required for long-term IOP control in AC and ACG patients. In SAC patients, surgery contributes to a small decrease in IOP, but it does not affect the number of AP required.

This abstract was presented at the 2022 ARVO Annual Meeting, held in Denver, CO, May 1-4, 2022, and virtually.

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