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Ophthalmology and Therapy

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Open Access 02-12-2023 | Trabeculectomy | ORIGINAL RESEARCH

Comparison of Long-Term Effects Following Phacoemulsification Combined with Goniosynechialysis and Trabeculectomy in Patients with Primary Angle-Closure Glaucoma and Cataract

Authors: Yang Zhang, Gangwei Cheng, Yao Chen, Ailing Bian, Qi Zhou, Lüe Li, Shunhua Zhang

Published in: Ophthalmology and Therapy | Issue 1/2024

Abstract

Introduction

Goniosynechialysis (Phaco-GSL) is a logical therapeutic approach for patients with primary angle-closure glaucoma (PACG) and cataract. The aim of this study was to compare the long-term effectiveness and safety of Phaco-GSL and trabeculectomy (TRB) in the management of PACG with coexisting cataract.

Methods

A review was conducted on 96 Chinese patients (96 eyes) with PACG and cataract from Peking Union Medical College Hospital (PUMCH). Among them, 56 patients underwent Phaco-GSL, while 40 underwent TRB. Intraocular pressure (IOP), best corrected visual acuity (BCVA), use of supplemental antiglaucoma medical therapy, surgery success rates, and complications for both procedures were assessed.

Results

The average follow-up period was 50.3 ± 18.7 months in the Phaco-GSL group and 61.2 ± 15.1 months in the TRB group. At the final follow-up, IOP decreased from 27.0 ± 11.1 mmHg to 13.5 ± 2.1 mmHg in the Phaco-GSL group and in the TRB group IOP decreased from 27.1 ± 7.7 mmHg to 16.5 ± 5.5 mmHg. The long-term postoperative IOP in the Phaco-GSL group was significantly lower than that in the TRB group. There was a statistically significant reduction in medication usage in both groups, with the TRB group having a higher number of postoperative medications at the final follow-up. The incidence of postoperative complications was significantly higher in the TRB group compared to the Phaco-GSL group.

Conclusions

Phaco-GSL is the recommended surgical approach for Chinese patients with primary angle-closure glaucoma (PACG) and cataract. Compared to traditional TRB, eyes undergoing Phaco-GSL show a reduced requirement for antiglaucomatous medications, improved management of IOP, decreased risk of complications, and higher long-term cumulative probability of treatment success for patients with PACG.

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Title: Comparison of Long-Term Effects Following Phacoemulsification Combined with Goniosynechialysis and Trabeculectomy in Patients with Primary Angle-Closure Glaucoma and Cataract
Authors: Yang Zhang
Gangwei Cheng
Yao Chen
Ailing Bian
Qi Zhou
Lüe Li
Shunhua Zhang
Publication date: 02-12-2023
Publisher: Springer Healthcare
Keywords: Trabeculectomy
Glaucoma
Cataract
Published in: Ophthalmology and Therapy / Issue 1/2024
Print ISSN: 2193-8245
Electronic ISSN: 2193-6528
DOI: https://doi.org/10.1007/s40123-023-00823-9

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Abstract

Introduction

Methods

Results

Conclusions

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