Endoscope-assisted goniosynechialysis combined with phacoemulsification and intraocular lens implantation to manage primary angle-closure glaucoma

AIM:To describe and evaluate a new ophthalmic endoscope surgical technique combined with phacoemulsification andintraocular lens (IOL) implantation to treat goniosynechialysis and manage primary angle-closure glaucoma (PACG). METHODS:Endoscope-assisted goniosynechialysis combined with phacoemulsi...

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Main Authors: Yu-Ping Zou, Jing Chen and
Format: Article
Language:English
Published: Press of International Journal of Ophthalmology (IJO PRESS) 2013-04-01
Series:International Journal of Ophthalmology
Subjects:
Online Access:http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3633756/
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author Yu-Ping Zou
Jing Chen and
author_facet Yu-Ping Zou
Jing Chen and
author_sort Yu-Ping Zou
collection DOAJ
description AIM:To describe and evaluate a new ophthalmic endoscope surgical technique combined with phacoemulsification andintraocular lens (IOL) implantation to treat goniosynechialysis and manage primary angle-closure glaucoma (PACG). METHODS:Endoscope-assisted goniosynechialysis combined with phacoemulsification andIOL implantation was performed in 32 eyes of 29 patients with PACG. Regular follow-up was performed 1 week and 1 month, 3, and 6 months after surgery to assess complications, intraocular pressure (IOP), anterior chamber depth, visual acuity, and anterior chamber angle. RESULTS:Preoperative mean IOP was 24.88±7.22mmHg with pharmacological treatment, and was 13.70±4.02, 13.06±3.74, 14.29±4.70, and 14.33±5.01mmHg 1 week, 1 month, 3 months, and 6 months after surgery, respectively. The postoperative decrease in IOP was significant (P<0.05). The rate for all eyes with IOP of 21mmHg or less was 93.8% (30 eyes) at the final visit without ocular hypotensive agents. The average preoperative anterior chamber depth was 1.60±0.64mm, and this value significantly increased to 2.72±0.62, 2.76±0.70, 2.73±0.68, and 2.74±0.71mm at 1 week, 1 month, 3 months, and 6 months, respectively. Visual acuity was improved in 28 eyes (87.5%) at 6 months postoperatively. The anterior chamber angle had increased in 25 eyes (78.1%) at the final visit; it was adhesive 90°-180° in 6 eyes, 180°-270° in only 1 eye. Two eyes exhibited minimal hyphema in the early postoperative period, but it could gradually be absorbed. Fibrinous reaction was observed in five eyes and spontaneously disappeared within 7 days. No shallow anterior chamber, iridodialysis, choroidal detachment, or malignant glaucoma was found in any eyes. CONCLUSION:Endoscope-assisted goniosynechialysis combined with phacoemulsification and IOL implantation to manage PACG has several advantages, including optimized visualization, greater accuracy, and improved safety. Our results suggest that it has certain curative effects and clinical application value.
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spelling doaj.art-df91c945a67546b2933635636e882d332022-12-22T02:36:10ZengPress of International Journal of Ophthalmology (IJO PRESS)International Journal of Ophthalmology2222-39592227-48982013-04-016217417710.3980/j.issn.2222-3959.2013.02.13Endoscope-assisted goniosynechialysis combined with phacoemulsification and intraocular lens implantation to manage primary angle-closure glaucomaYu-Ping ZouJing Chen andAIM:To describe and evaluate a new ophthalmic endoscope surgical technique combined with phacoemulsification andintraocular lens (IOL) implantation to treat goniosynechialysis and manage primary angle-closure glaucoma (PACG). METHODS:Endoscope-assisted goniosynechialysis combined with phacoemulsification andIOL implantation was performed in 32 eyes of 29 patients with PACG. Regular follow-up was performed 1 week and 1 month, 3, and 6 months after surgery to assess complications, intraocular pressure (IOP), anterior chamber depth, visual acuity, and anterior chamber angle. RESULTS:Preoperative mean IOP was 24.88±7.22mmHg with pharmacological treatment, and was 13.70±4.02, 13.06±3.74, 14.29±4.70, and 14.33±5.01mmHg 1 week, 1 month, 3 months, and 6 months after surgery, respectively. The postoperative decrease in IOP was significant (P<0.05). The rate for all eyes with IOP of 21mmHg or less was 93.8% (30 eyes) at the final visit without ocular hypotensive agents. The average preoperative anterior chamber depth was 1.60±0.64mm, and this value significantly increased to 2.72±0.62, 2.76±0.70, 2.73±0.68, and 2.74±0.71mm at 1 week, 1 month, 3 months, and 6 months, respectively. Visual acuity was improved in 28 eyes (87.5%) at 6 months postoperatively. The anterior chamber angle had increased in 25 eyes (78.1%) at the final visit; it was adhesive 90°-180° in 6 eyes, 180°-270° in only 1 eye. Two eyes exhibited minimal hyphema in the early postoperative period, but it could gradually be absorbed. Fibrinous reaction was observed in five eyes and spontaneously disappeared within 7 days. No shallow anterior chamber, iridodialysis, choroidal detachment, or malignant glaucoma was found in any eyes. CONCLUSION:Endoscope-assisted goniosynechialysis combined with phacoemulsification and IOL implantation to manage PACG has several advantages, including optimized visualization, greater accuracy, and improved safety. Our results suggest that it has certain curative effects and clinical application value.http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3633756/angle closureglaucomagoniosynechialysisendoscopephacoemulsification
spellingShingle Yu-Ping Zou
Jing Chen and
Endoscope-assisted goniosynechialysis combined with phacoemulsification and intraocular lens implantation to manage primary angle-closure glaucoma
International Journal of Ophthalmology
angle closure
glaucoma
goniosynechialysis
endoscope
phacoemulsification
title Endoscope-assisted goniosynechialysis combined with phacoemulsification and intraocular lens implantation to manage primary angle-closure glaucoma
title_full Endoscope-assisted goniosynechialysis combined with phacoemulsification and intraocular lens implantation to manage primary angle-closure glaucoma
title_fullStr Endoscope-assisted goniosynechialysis combined with phacoemulsification and intraocular lens implantation to manage primary angle-closure glaucoma
title_full_unstemmed Endoscope-assisted goniosynechialysis combined with phacoemulsification and intraocular lens implantation to manage primary angle-closure glaucoma
title_short Endoscope-assisted goniosynechialysis combined with phacoemulsification and intraocular lens implantation to manage primary angle-closure glaucoma
title_sort endoscope assisted goniosynechialysis combined with phacoemulsification and intraocular lens implantation to manage primary angle closure glaucoma
topic angle closure
glaucoma
goniosynechialysis
endoscope
phacoemulsification
url http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3633756/
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