Top

Published in:

18-04-2023 | Glaucoma | Original Paper

One-year outcomes of combined phacoemulsification and viscogoniosynechialysis with and without endoscopic cyclophotocoagulation in primary angle-closure glaucoma

Authors: Massood Mohammadi, Mostafa Daraby, Yadollah Eslami, Ghasem Fakhraie, Zakieh Vahedian, Mona Safizadeh, Reza Sadeghi, Alireza Beikmarzehei, Seyed Mehdi Tabatabaei

Published in: International Ophthalmology | Issue 9/2023

Abstract

Purpose

To compare the outcomes of combined phacoemulsification and viscogoniosynechialysis (VGSL) with and without endoscopic cyclophtocoagulation (ECP) in primary angle-closure glaucoma (PACG).

Methods

In this prospective interventional case series 52 eyes of 50 patients were enrolled. Twenty-seven eyes underwent combined phacoemulsification and VGSL (PV group) and 25 eyes underwent the same procedure plus circumferential ECP (PVE group). All eyes were followed 1 day, 1 week, 3 months, 6 months, and 1 year after the procedure. Intraocular pressure and antiglaucoma medications were compared between and within groups using generalized estimating equations. Kaplan–Meier survival analysis was carried out to compare intensity to failure between groups.

Results

The mean ± SD age was 63.23 ± 6.87 years and 50% of the cases were male in the entire group. Intraocular pressure (IOP) and antiglaucoma medications were significantly reduced at all time points in comparison with the baseline in both groups (p < 0.05). There was no significant difference between groups in either IOP or medications at specific time points (p > 0.05). One eye in each group developed a fibrinous reaction in the postoperative period. There was no statistically significant difference between groups regarding the intensity to failure (P = 0.169).

Conclusion

There were no significant differences in IOP and medication reduction between groups. Also, the complications were comparable between groups.

Tham YC, Li X, Wong TY, Quigley HA, Aung T, Cheng CY (2014) Global prevalence of glaucoma and projections of glaucoma burden through 2040: a systematic review and meta-analysis. Ophthalmology 121(11):2081–2090. https://doi.org/10.1016/j.ophtha.2014.05.013CrossRefPubMed

Kreft D, Doblhammer G, Guthoff RF, Frech S (2021) Incidence, individual, and macro level risk factors of severe binocular visual impairment and blindness in persons aged 50 and older. PLoS ONE 16(5):e0251018. https://doi.org/10.1371/journal.pone.0251018CrossRefPubMedPubMedCentral

Sun X, Dai Y, Chen Y et al (2017) Primary angle closure glaucoma: What we know and what we don’t know. Prog Retin Eye Res 57:26–45. https://doi.org/10.1016/j.preteyeres.2016.12.003CrossRefPubMed

Foster PJ, Buhrmann R, Quigley HA, Johnson GJ (2002) The definition and classification of glaucoma in prevalence surveys. Br J Ophthalmol 86(2):238–242. https://doi.org/10.1136/bjo.86.2.238CrossRefPubMedPubMedCentral

Wright C, Tawfik MA, Waisbourd M, Katz LJ (2016) Primary angle-closure glaucoma: an update. Acta Ophthalmol (Copenh) 94(3):217–225. https://doi.org/10.1111/aos.12784CrossRef

Ng WT, Morgan W (2012) Mechanisms and treatment of primary angle closure: a review. Clin Exp Ophthalmol 40(4):e218-228. https://doi.org/10.1111/j.1442-9071.2011.02604.xCrossRefPubMed

George R, Paul PG, Baskaran M et al (2003) Ocular biometry in occludable angles and angle closure glaucoma: a population based survey. Br J Ophthalmol 87(4):399–402. https://doi.org/10.1136/bjo.87.4.399CrossRefPubMedPubMedCentral

Moghimi S, Torkashvand A, Mohammadi M et al (2018) Classification of primary angle closure spectrum with hierarchical cluster analysis. PLoS ONE 13(7):e199157. https://doi.org/10.1371/journal.pone.0199157CrossRef

Moghimi S, Chen R, Hamzeh N, Khatibi N, Lin SC (2016) Qualitative evaluation of anterior segment in angle closure disease using anterior segment optical coherence tomography. J Curr Ophthalmol 28(4):170–175. https://doi.org/10.1016/j.joco.2016.06.005CrossRefPubMedPubMedCentral

10.

Kansara S, Blieden LS, Chuang AZ et al (2016) Effect of laser peripheral iridotomy on anterior chamber angle anatomy in primary angle closure spectrum eyes. J Glaucoma 25(5):e469-474. https://doi.org/10.1097/IJG.0000000000000293CrossRefPubMedPubMedCentral

11.

Lai J, Choy BN, Shum JW (2016) Management of primary angle-closure glaucoma. Asia-Pac J Ophthalmol 5(1):59–62CrossRef

12.

Choi JS, Kim YY (2005) Progression of peripheral anterior synechiae after laser iridotomy. Am J Ophthalmol 140(6):1125–1127. https://doi.org/10.1016/j.ajo.2005.06.018CrossRefPubMed

13.

Azuara-Blanco A, Burr J, Ramsay C et al (2016) Effectiveness of early lens extraction for the treatment of primary angle-closure glaucoma (EAGLE): a randomised controlled trial. Lancet Lond Engl 388(10052):1389–1397. https://doi.org/10.1016/S0140-6736(16)30956-4CrossRef

14.

Razeghinejad MR (2008) Combined phacoemulsification and viscogoniosynechialysis in patients with refractory acute angle-closure glaucoma. J Cataract Refract Surg 34(5):827–830. https://doi.org/10.1016/j.jcrs.2008.01.014CrossRefPubMed

15.

Razeghinejad MR, Rahat F (2010) Combined phacoemulsification and viscogoniosynechialysis in the management of patients with chronic angle closure glaucoma. Int Ophthalmol 30(4):353–359. https://doi.org/10.1007/s10792-010-9353-4CrossRefPubMed

16.

Lim R (2022) The surgical management of glaucoma: a review. Clin Exp Ophthalmol 50(2):213–231. https://doi.org/10.1111/ceo.14028CrossRefPubMed

17.

Hansapinyo L, Choy BNK, Lai JSM, Tham CC (2020) Phacoemulsification versus phacotrabeculectomy in primary angle-closure glaucoma with cataract: long-term clinical outcomes. J Glaucoma 29(1):15–23. https://doi.org/10.1097/IJG.0000000000001397CrossRefPubMed

18.

El Sayed YM, Elhusseiny AM, Albalkini AS, El Sheikh RH, Osman MA (2019) Mitomycin C-augmented phacotrabeculectomy versus phacoemulsification in primary angle-closure glaucoma: a randomized controlled study. J Glaucoma 28(10):911–915. https://doi.org/10.1097/IJG.0000000000001345CrossRefPubMed

19.

Senthil S, Rao HL, Choudhari N, Garudadri C (2022) Phacoemulsification versus phacotrabeculectomy in medically controlled primary angle closure glaucoma with cataract in an indian cohort: a randomized controlled trial. Int Ophthalmol 42(1):35–45. https://doi.org/10.1007/s10792-021-01997-6CrossRefPubMed

20.

Lavia C, Dallorto L, Maule M, Ceccarelli M, Fea AM (2017) Minimally-invasive glaucoma surgeries (MIGS) for open angle glaucoma: a systematic review and meta-analysis. PLoS ONE 12(8):e183142. https://doi.org/10.1371/journal.pone.0183142CrossRef

21.

Siegel MJ, Boling WS, Faridi OS et al (2015) Combined endoscopic cyclophotocoagulation and phacoemulsification versus phacoemulsification alone in the treatment of mild to moderate glaucoma. Clin Exp Ophthalmol 43(6):531–539. https://doi.org/10.1111/ceo.12510CrossRefPubMed

22.

Francis BA, Berke SJ, Dustin L, Noecker R (2014) Endoscopic cyclophotocoagulation combined with phacoemulsification versus phacoemulsification alone in medically controlled glaucoma. J Cataract Refract Surg 40(8):1313–1321. https://doi.org/10.1016/j.jcrs.2014.06.021CrossRefPubMed

23.

Hollander DA, Pennesi ME, Alvarado JA (2017) Management of plateau iris syndrome with cataract extraction and endoscopic cyclophotocoagulation. Exp Eye Res 158:190–194. https://doi.org/10.1016/j.exer.2016.07.018CrossRefPubMed

24.

Saw SM, Gazzard G, Friedman DS (2003) Interventions for angle-closure glaucoma: an evidence-based update. Ophthalmology 110(10):1869–1878. https://doi.org/10.1016/S0161-6420(03)00540-2CrossRefPubMed

25.

Radhakrishnan S, Chen PP, Junk AK, Nouri-Mahdavi K, Chen TC (2018) Laser peripheral iridotomy in primary angle closure: a report by the American academy of ophthalmology. Ophthalmology 125(7):1110–1120CrossRefPubMed

26.

Song BJ, Ramanathan M, Morales E et al (2016) Trabeculectomy and combined phacoemulsification-trabeculectomy: outcomes and risk factors for failure in primary angle closure glaucoma. J Glaucoma 25(9):763–769. https://doi.org/10.1097/IJG.0000000000000493CrossRefPubMedPubMedCentral

27.

Tsai HY, Liu CJ, Cheng CY (2009) Combined trabeculectomy and cataract extraction versus trabeculectomy alone in primary angle-closure glaucoma. Br J Ophthalmol 93(7):943–948. https://doi.org/10.1136/bjo.2008.151803CrossRefPubMed

28.

Wang M, Fang M, Bai Y et al (2012) Comparison of combined phacotrabeculectomy with trabeculectomy only in the treatment of primary angle-closure glaucoma. Chin Med J (Engl) 125(8):1429–1433PubMed

29.

Ghadamzadeh M, Karimi F, GhasemiMoghaddam S, Daneshvar R (2022) Anterior chamber angle changes in primary angle-closure glaucoma following phacoemulsification versus phacotrabeculectomy: a prospective randomized clinical trial. J Glaucoma 31(3):147–155. https://doi.org/10.1097/IJG.0000000000001977CrossRefPubMed

30.

Morales J, Al Qahtani M, Khandekar R et al (2015) Intraocular pressure following phacoemulsification and endoscopic cyclophotocoagulation for advanced glaucoma: 1-year outcomes. J Glaucoma 24(6):e157-162. https://doi.org/10.1097/IJG.0000000000000228CrossRefPubMed

31.

Lin MM, Rageh A, Turalba AV et al (2019) Differential efficacy of combined phacoemulsification and endocyclophotocoagulation in open-angle glaucoma versus angle-closure glaucoma. J Glaucoma 28(5):473–480. https://doi.org/10.1097/IJG.0000000000001225CrossRefPubMed

32.

Young CEC, Seibold LK, Kahook MY (2020) Cataract surgery and intraocular pressure in glaucoma. Curr Opin Ophthalmol 31(1):15–22. https://doi.org/10.1097/ICU.0000000000000623CrossRefPubMed

33.

Izquierdo Villavicencio JC, AgudeloArbelaez N, Lastra BR et al (2019) Primary outcomes of patients with chronic angle-closure glaucoma treated with combined phacoemulsification, viscogoniosynechialysis, and endocyclophotocoagulation. J Ophthalmol 2019:6378489. https://doi.org/10.1155/2019/6378489CrossRefPubMedPubMedCentral

34.

Panse K, Le C, Hubbell M, Ayyala RS (2019) Surgical outcomes of phacoemulsification/goniosynechialysis with and without endocyclophotocoagulation in patients with chronic angle closure glaucoma. Indian J Ophthalmol 67(3):366–370. https://doi.org/10.4103/ijo.IJO_895_18CrossRefPubMedPubMedCentral

35.

Lai ISW, Chan NCY, Ling A et al (2021) Combined phacoemulsification-endoscopic cyclophotocoagulation versus phacoemulsification alone in primary angle-closure glaucoma: a pilot randomized controlled trial. Ophthalmol Glaucoma 4(6):589–596. https://doi.org/10.1016/j.ogla.2021.03.007CrossRefPubMed

36.

Francis BA, Pouw A, Jenkins D et al (2016) Endoscopic cycloplasty (ECPL) and lens extraction in the treatment of severe plateau iris syndrome. J Glaucoma 25(3):e128-133. https://doi.org/10.1097/IJG.0000000000000156CrossRefPubMed

37.

Pathak-Ray V (2019) Intermediate results of phaco-endocycloplasty in an exclusive cohort of angle closure glaucoma: potential for change. Int Ophthalmol 39(10):2257–2265. https://doi.org/10.1007/s10792-018-01062-9CrossRefPubMed

Title: One-year outcomes of combined phacoemulsification and viscogoniosynechialysis with and without endoscopic cyclophotocoagulation in primary angle-closure glaucoma
Authors: Massood Mohammadi
Mostafa Daraby
Yadollah Eslami
Ghasem Fakhraie
Zakieh Vahedian
Mona Safizadeh
Reza Sadeghi
Alireza Beikmarzehei
Seyed Mehdi Tabatabaei
Publication date: 18-04-2023
Publisher: Springer Netherlands
Keywords: Glaucoma
Trabeculectomy
Cyclophotocoagulation
Published in: International Ophthalmology / Issue 9/2023
Print ISSN: 0165-5701
Electronic ISSN: 1573-2630
DOI: https://doi.org/10.1007/s10792-023-02723-0

2024 ASCO Annual Meeting

Springer Medicine

One-year outcomes of combined phacoemulsification and viscogoniosynechialysis with and without endoscopic cyclophotocoagulation in primary angle-closure glaucoma

Abstract

Purpose

Methods

Results

Conclusion

2024 ASCO Annual Meeting

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

Please log in to get access to this content

Other articles of this Issue 9/2023

Microbial distributions in the conjunctiva and lacrimal sacs of patients with chronic dacryocystitis in a tertiary hospital

Binocular metamorphopsia in patients with branch retinal vein occlusion: a multi-center study

Long non-coding RNA nuclear paraspeckle assembly transcript 1 downregulation protects lens epithelial cells from oxidative stress-induced apoptosis by regulating the microRNA-124-3p/death-associated protein kinase 1 axis in age-related cataract

Orbital inflammation following COVID-19 vaccination: A case series and literature review

Incomplete retinal vascularization with retinopathy of prematurity-like ridges in healthy full-term newborns

Evaluation of peripheral anterior synechia formation following gonioscopy-assisted transluminal trabeculotomy surgery