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Goniosynechialysis with endo-mirror combined with cataract surgery for primary angle closure glaucoma

Poster Details

First Author: N.Sugiyama JAPAN

Co Author(s):    S. Yaguchi   M. Soda   Y. Asano   D. Yamaguchi     

Abstract Details



Purpose:

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).

Setting:

Department of Ophthalmology, Showa University, School of Medicine, Fujigaoka Rehabilitation Hospital.

Methods:

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 patient’s head to be tilted. However, many elderly patients have neck-related problems, so we performed GSL with the EM without tilting the patient’s 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.

Results:

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.

Conclusions:

Gonioscopy using the EM is a simple, safe method and does not need the patient’s head to be tilted. Also GSL by iris stretching is useful and effective in reducing IOP.

Financial Disclosure:

NONE

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