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First Author: N.Sugiyama JAPAN
Co Author(s): S. Yaguchi M. Soda Y. Asano D. Yamaguchi
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To evaluate the efficacy and safety of a new observation?method of angle views and Goniosynechialysis ?GSL?performed by iris stretching using?an endo-mirror(EM) for uncontrolled primary angle-closure glaucoma(PACG).
Department of Ophthalmology, Showa University, School of Medicine, Fujigaoka Rehabilitation Hospital.
The EM instrument was originally designed to confirm the precise adherence of an implant needle to the ciliary sulcus during suturing of the IOL. Intraoperative gonioscopy is usually performed with a Swan-Jacob gonioprism, which requires the patients head to be tilted. However, many elderly patients have neck-related problems, so we performed GSL with the EM without tilting the patients head after phacoemulsification and posterior chamber intraocular lens implantation on 5 eyes for PACG with peripheral anterior synechia (PAS) index ?50%. GSL was performed by iris stretching using anterior capsular forceps. The average follow-up period was 16.0ḟ13.6 months.
In all cases, gonioscopy by the EM showed released PAS after GSL. Pupilloplasty was performed on 1 eye. The mean intraocular pressure decreased from 30.0ḟ7.5mmHg to 12.3ḟ5.4mmHg at 3 months after surgery.The corneal endothelium cell density rate of decline was 5.1%. Inoperative complications included angle hemorrhage and postoperative complications included fibrin reaction were manageable.
Gonioscopy using the EM is a simple, safe method and does not need the patients head to be tilted. Also GSL by iris stretching is useful and effective in reducing IOP.