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Safety and efficacy of incisional goniotomy as an adjunct with phacoemulsification in primary angle-closure glaucoma.
Gupta, Shikha; Sethi, Anin; Yadav, Suresh; Azmira, Kishan; Singh, Abhishek; Gupta, Viney.
Afiliação
  • Gupta S; From the Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India.
J Cataract Refract Surg ; 47(4): 504-511, 2021 04 01.
Article em En | MEDLINE | ID: mdl-33181630
PURPOSE: To evaluate the intraocular pressure (IOP)-lowering efficacy and safety of incisional goniotomy as an adjunct to phacoemulsification in primary angle-closure glaucoma (PACG) patients. METHODS: Consecutive patients with PACG (high or borderline IOP) deemed fit for phacoemulsification were enrolled. After phacoemulsification, incisional goniotomy was performed with or without goniosynechialysis. Patient demographic profile, clinical data, and adverse events, if any, were analyzed during at least a 6-month follow-up period. Success was defined as IOP of 18 mm Hg or lesser with or without medications. SETTING: Tertiary care Ophthalmic hospital. DESIGN: Prospective interventional case series. RESULTS: Of 46 eyes (38 patients) included, 69.6% eyes were classified as having advanced glaucoma. The mean treated IOP decreased by 7.3 ± 1.0 (SE) mm Hg (95% CI, 5.2-9.3) from 21.4 ± 6.6 to 14.2 ± 3.7 mm Hg at a mean duration of 11.7 ± 5.5 months (6-22 months) postoperatively (P < .001, paired t test). There was 66.6% reduction in median number of hypotensive medications (P < .001, Wilcoxon signed-rank test). Observed complications included hyphema (13 eyes [28%]), IOP spike (3 eyes [6.5%]), and cyclodialysis (1 eye [2.17%]). High treated IOP and number of medications were significantly associated with failure in univariate analysis (P < .05, Fisher exact test). The cumulative survival probability for qualified success at 22 months was 87.8% ± 0.07 (95% CI, 0.65-0.96). CONCLUSIONS: Incisional goniotomy as an adjunct with phacoemulsification resulted in a significant and sustained reduction in IOP along with decrease in number of glaucoma medications in chronic PACG eyes, irrespective of the disease stage.
Assuntos

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Trabeculectomia / Glaucoma de Ângulo Fechado / Facoemulsificação Tipo de estudo: Observational_studies / Risk_factors_studies Limite: Humans Idioma: En Revista: J Cataract Refract Surg Assunto da revista: OFTALMOLOGIA Ano de publicação: 2021 Tipo de documento: Article País de afiliação: Índia

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Trabeculectomia / Glaucoma de Ângulo Fechado / Facoemulsificação Tipo de estudo: Observational_studies / Risk_factors_studies Limite: Humans Idioma: En Revista: J Cataract Refract Surg Assunto da revista: OFTALMOLOGIA Ano de publicação: 2021 Tipo de documento: Article País de afiliação: Índia