AIM: To investigate the efficacy and safety of 90° inferonasal sectoral goniotomy with an micro-vitreoretinal(MVR)blade in patients with mild-to-moderate primary open-angle glaucoma(POAG)and pseudoexfoliation glaucoma(PEXG).METHODS: This retrospective study included data from 60 patients(60 eyes)who underwent stand-alone goniotomy or goniotomy with phacoemulsification between August 2021 and January 2023, and 45 eyes underwent goniotomy combined with phacoemulsification, and 15 eyes underwent goniotomy as a stand-alone procedure. Postoperatively, intraocular pressure(IOP)and the number of medications were collected at 1, 3, 6, and 12 mo. The side effects of surgery were recorded 1 d, 1 wk, and 1, 3, 6, and 12 mo postoperatively. The primary outcomes were a reduction in IOP of at least 20% from baseline and a decrease in the number of antiglaucomatous medications in 1 a postoperatively. The secondary outcome was surgical success, defined as an IOP<18 mmHg with(qualified)or without(complete)antiglaucomatous medication at 1 a postoperatively.RESULTS: At the end of 1 a, 78% of patients achieved both a >20% reduction in IOP and a reduction in the number of medications used. Overall success was achieved in 63% of patients. Microhyphaema was the most common complication, none of the patients experienced a complication requiring surgical intervention.CONCLUSION: Sectoral inferonasal goniotomy with an MVR blade significantly reduced IOP and the number of medications required in patients with POAG and PEXG, and 1-year follow-up after goniotomy showed that the need for filtering surgery was either eliminated or delayed in a significant number of patients.

AIM:To investigate the changes in anterior segment morphology using the Pentacam Schiempflug imaging system after uneventful phacoemulsification in pseudoexfoliation syndrome(PES).

METHODS:We enrolled 42 cataractous eyes of 31 PES patients undergoing cataract extraction in this prospective study, 42 cataractous eyes of 27 patients without pseudoexfoliation comprised a control group. Intraocular pressure(IOP),anterior chamber depth(ACD), anterior chamber volume(ACV), anterior chamber angle width(ACA)and pupil diameter(PD)measurements were obtained preoperatively, and at 1 and 3mo postoperatively with the Pentacam. For the variables between the pre- and post operative periods; t-test was used.

RESULTS: In PES group, the mean preoperative IOP level was significantly higher than the control group(P=0.017). In both groups, the differences in ACD, ACV, ACA and IOP values measured preoperatively and postoperatively at 1, and 3mo were statistically significant(P<0.05). When two groups were compared with each other, while reduction in IOP levels were more dramatic in PES group; increase in ACD,ACV and ACA were similar in both groups. Preoperative PD measurements were statistically higher than postoperative values(P<0.05)in PES group. Changes in IOP, ACD, ACV, ACA and PD were stabilized at 3mo postoperatively in both groups.

CONCLUSION:Uneventful phacoemulsification significantly reduces IOP, increases ACD,ACV and ACA in eyes with and without PES. Changes in ACD, ACV, ACA, PD and IOP remain stable at 3mo postoperatively. Although IOP reduction is more evident in PES group, cataractous eyes with and without PES exhibits similar anterior segment features after surgery. An early cataract extraction in pseudoexfoliation not only provides a wide and deep anterior chamber, but also leads to a stabile IOP control similar to eyes without PES.