[Endoscope-assisted goniosynechialysis with phacoemulsification and intraocular lens implantation for treatment of primary angle-closure glaucoma].

ABSTRACT

OBJECTIVE: To evaluate the early therapeutic effect of endoscope-assisted goniosynechialysis combined with phacoemulsification and intraocular lens implantation for management of primary angle-closure glaucoma. METHODS: Endoscope-assisted goniosynechialysis combined with phacoemulsification and intraocular lens implantation was performed in 31 patients (31 eyes) with primary angle-closure glaucoma, including 17 eyes with acute angle closure glaucoma and 14 eyes with chronic angle closure glaucoma. The patients were regularly followed up to observe the postoperative complications and changes in the intraocular pressure, visual acuity, anterior chamber depth and anterior chamber angle. RESULTS: Hyphema occurred in 3 eyes after the operation and was absorbed gradually. The intraocular pressure decreased significantly in all the patients after the operation (P<0.05) but showed no significant differences between the acute and chronic cases (P>0.05). The intraocular pressure was over 21 mmHg in only one eye in the chronic group, and could be controlled by ocular hypotensive agents. Visual acuity improved and the anterior chamber depth increased in all the patients, showing no significant differences between the two groups (P>0.05). The anterior chamber angle all opened after the operation in 16 eyes (94.1%) in acute group, a rate significantly higher than that in the chronic group (9 eyes, 64.3%) (P<0.05). Anterior chamber angle was adhesive in 1 eye in the acute group and in 5 eyes in the chronic group. No further extension of goniosynechiae was found in these cases during the follow-up period. CONCLUSIONS: Endoscope-assisted goniosynechialysis has such advantages as optimized visualization, accuracy and safety in the management of primary angle-closure glaucoma.