Phacoemulsification, visco-goniosynechialysis, and goniotomy in patients with primary angle-closure glaucoma: A comparative study

2019 ◽  
pp. 112067211987933 ◽  
Author(s):  
Saeed Shokoohi-Rad ◽  
Farshid Karimi ◽  
Siamak Zarei-Ghanavati ◽  
Hossein Tireh
Keyword(s):  
Optical Coherence Tomography ◽  
Intraocular Pressure ◽  
Anterior Segment ◽  
Angle Closure Glaucoma ◽  
Angle Closure ◽  
Optical Coherence ◽  
Antiglaucoma Medication ◽  
Primary Angle Closure ◽  
Primary Angle Closure Glaucoma ◽  
The Difference

Objective: The aim of this study was to evaluate the effects of goniotomy on patients with primary angle-closure glaucoma who underwent “phacoemulsification and visco-goniosynechialysis.” Materials and methods: This prospective randomized clinical trial was carried out on 63 eyes of 61 patients (48–85 years) with primary angle-closure glaucoma who were enrolled. The subjects were randomly assigned into two groups. In the first group (32 eyes) and the second group (31 eyes), the patients underwent “phacoemulsification + visco-goniosynechialysis + goniotomy” and “phacoemulsification + visco-goniosynechialysis,” respectively. Intraocular pressure and antiglaucoma medication were evaluated (1 week, as well as 1, 3, and 6 months after the surgery). Anterior segment optical coherence tomography parameters (Casia, Tomey, USA) and goniotomy were evaluated preoperatively and 6 months after the surgery. Results: The mean intraocular pressure lowering the effects in the “phacoemulsification + visco-goniosynechialysis + goniotomy” group was higher than that in the “phacoemulsification + visco-goniosynechialysis” group (6.93 and 4.6, respectively). Furthermore, the difference in intraocular pressure between the two groups was significant at 3 months (P = 0.014) and 6 months (P = 0.021) after the surgery. There was no difference in anterior segment optical coherence tomography findings before the intervention; however, after the intervention, the anterior segment optical coherence tomography indices were significantly different between the two groups. Moreover, the difference in “phacoemulsification + visco-goniosynechialysis + goniotomy” indices was more than the changes in the “phacoemulsification + visco-goniosynechialysis” group. Conclusion: The results of this study showed that phacoemulsification + visco-goniosynechialysis + goniotomy is a more effective surgery than phacoemulsification + visco-goniosynechialysis alone in undercounted primary angle-closure glaucoma.

scholarly journals Medium-term Anatomical Results of Laser Peripheral Iridoplasty: An Anterior Segment Optical Coherence Tomography Study

2017 ◽  
Vol 11 (3) ◽  
pp. 113-119 ◽  
Author(s):  
Joobin Hooshmand ◽  
James CY Leong ◽  
Jeremy O'Connor ◽  
Ghee S Ang ◽  
Anthony P Wells
Keyword(s):  
Optical Coherence Tomography ◽  
Cataract Surgery ◽  
Anterior Segment ◽  
Angle Closure Glaucoma ◽  
Angle Closure ◽  
Final Visit ◽  
Optical Coherence ◽  
Medium Term ◽  
Primary Angle Closure

ABSTRACT Aim To evaluate by anterior segment optical coherence tomography (AS-OCT) the medium-term (mean duration 3.2 years) anatomical changes in the anterior chamber angle (ACA) after laser peripheral iridoplasty. Materials and methods This is a longitudinal, retrospective case series of 31 eyes of 31 patients with primary angle-closure suspicion, primary angle closure (PAC), or primary angle-closure glaucoma (PACG) who underwent laser peripheral iridoplasty. All patients had persistent iridotrabecular contact (ITC) despite the presence of a patent peripheral iridotomy (PI). An AS-OCT was performed in dark conditions before and after laser iridoplasty. Quadrants of ITC, intraocular pressure (IOP), and the AS-OCT parameters of the temporal and nasal ACAs were measured and analyzed. Results Prior to iridoplasty, the average number of quadrants of ITC was 3.3. At the first postiridoplasty visit (mean duration 6.8 weeks), this reduced to 1.7 quadrants but increased to 1.9 by the final follow-up visit (mean duration 3.2 years). Twenty-five patients (80.1%) had less ITC at the first postlaser visit increasing to 27 (87.1%) patients by the final visit. Two (6.5%) required a second iridoplasty, while 3 (9.7%) required cataract surgery. All parameters of angle width showed a statistically significant increase in magnitude. All patients maintained IOP ≤ 21 mm Hg throughout the follow-up period. Conclusion Iridoplasty is a useful adjunct in widening the ACA, particularly in those with persistent angle closure after iridotomy but with no cataract. While not successful in all patients, it can act as a temporizing measure to widen the drainage angle until such time that cataract surgery can be performed. Clinical significance Laser peripheral iridoplasty can be used as an adjunct in angle-closure glaucoma patients with no cataract. How to cite this article Hooshmand J, Leong JCY, O'Connor J, Ang GS, Wells AP. Medium-term Anatomical Results of Laser Peripheral Iridoplasty: An Anterior Segment Optical Coherence Tomography Study. J Curr Glaucoma Pract 2017;11(3):113-119.

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