Surgical outcome and safety of peripheral iridectomy plus goniosynechialysis and goniotomy in the treatment of advanced primary angle-closure glaucoma
10.3760/cma.j.cn115989-20220819-00383
- VernacularTitle:周边虹膜切除联合房角分离及房角切开术治疗中晚期PACG的有效性及安全性评估
- Author:
Fengbin LIN
1
;
Ping LU
;
Yunhe SONG
;
Xinbo GAO
;
Yingzhe ZHANG
;
Xin NIE
;
Yuying PENG
;
Xiaoyan LI
;
Xiaomin ZHU
;
Hengli ZHANG
;
Yi ZHANG
;
Lin XIE
;
Guangxian TANG
;
Li TANG
;
Sujie FAN
;
Xiulan ZHANG
Author Information
1. 中山大学中山眼科中心 眼科学国家重点实验室 广东省眼科视觉科学重点实验室 广东省眼部疾病临床研究中心，广州 510060
- Keywords:
Glaucoma, angle-closure;
Surgery;
Multicenter study;
Goniotomy;
Goniosynechialysis;
Peripheral iridectomy;
Effectiveness;
Safety
- From:
Chinese Journal of Experimental Ophthalmology
2023;41(2):134-139
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To evaluate the preliminary effectiveness and safety of surgical peripheral iridectomy (SPI) combined with goniosynechilysis (GSL) and goniotomy (GT) in the treatment of advanced primary angle-closure glaucoma (PACG).Methods:A multicenter observational case series study was performed.Thirty-five eyes of 27 patients with advanced PACG, who underwent SPI+ GSL+ GT with a follow-up of at least 6 months, were included from August 2021 to January 2022 at Zhongshan Ophthalmic Center, Handan City Eye Hospital, Shijiazhuang People's Hospital, West China Hospital of Sichuan University, and the Third Affiliated Hospital of Chongqing Medical University.The mean follow-up time was 9(7, 10) months.Pre- and post-operative best corrected visual acuity (BCVA) and intraocular pressure (IOP) were measured with an ETDRS chart and a Goldmann applanation tonometer, respectively.The number of anti-glaucoma medications applied before and after surgery was recorded, and the complications after surgery were analyzed.Success rate of surgery was calculated.Complete surgical success was defined as an IOP of 5-18 mmHg (1 mmHg=0.133 kPa) and 20% reduction from baseline without anti-glaucoma medication or reoperation.Qualified success was defined as achieving criterion of complete success under anti-glaucoma medications.This study adhered to the Declaration of Helsinki.The study protocol was approved by the Ethics Committee of Zhongshan Ophthalmic Center, Sun Yat-sen University (No.2021KYPJ177). Written informed consent was obtained from each subject.Results:The mean preoperative IOP was (30.83±8.87)mmHg, which was significantly decreased to (15.69±3.70)mmHg at 6 months after the surgery ( t=8.588, P<0.001), with a 44.00% (34.78%, 60.00%) decline of 13.00(8.00, 21.00)mmHg.The median number of anti-glaucoma medications was significantly reduced from 2(0, 3) preoperatively to 0 (0, 1) postoperatively ( Z=-3.659, P<0.001). The mean preoperative and postoperative 6-month BCVA were 0.80(0.63, 1.00) and 0.80(0.60, 1.00), respectively, showing no significant difference ( Z=-0.283, P=0.777). Complete surgical success rate was 62.86%(22/35), and the qualified success rate was 91.43%(32/35). Surgical complications mainly included hyphema (6/35), IOP spike (3/35), and shallow anterior chamber (4/35). There was no vision-threatening complication. Conclusions:SPI+ GSL+ GT is preliminarily effective and safe in the treatment of advanced PACG, which provides a new option for PACG.
