Results of Combined Phacoemulsification and Goniosynechialysis in the Management of Refractory Acute Angle Closure Glaucoma in Ratchaburi Hospital

Supaporn Trakanwitthayarak¹

Affiliation : ¹ Department of Ophthalmology, Ratchaburi Hospital, Ratchaburi, Thailand

Objective: To assess the effectiveness of combined phacoemulsification and goniosynechialysis (PE-GSL) of angle closure glaucoma in patients with uncontrolled intraocular pressure (IOP) and persistent peripheral anterior synechiae (PAS) initially presented with acute angle closure attack.
Materials and Methods: The present study was a retrospective cohort study of medical records of Thai glaucoma patients comprising 19 eyes of 19 patients (13 females and 6 males) with acute angle closure attacks. All patients were performed with PE-GSL
Results: There were statistically significant differences between preoperative and postoperative IOP, PAS, and the number of medications required for IOP control. Postoperative visual acuities were improved. At the final examination for each patient, IOP was 12.15±1.57 mmHg (range 10 to 16). The extent of recurrent PAS was 66.32±40.72° (range 0 to 90), and the number of antiglaucoma medications was 0 (range 0 to 2). IOP was less than 20 mmHg in 16 eyes (80%) without medications. Three eyes were controlled with medications. In the 16 eyes with successful PE-GSL, the mean time between the angle closure attack and surgery was 7.5±5.6 weeks.
Conclusion: PE-GSL are effective in decreasing IOP, PAS, and medications, as well as improvement of visual acuity in eyes with uncontrolled IOP and persistent PAS in patients who initially presented with acute angle closure attacks.

Received 21 August 2023 | Revised 12 October 2023 | Accepted 24 October 2023
DOI: 10.35755/jmedassocthai.2023.12.13928

Keywords : Angle-closure glaucoma; Phacoemulsification; Goniosynechialysis; Cataract; IOP

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