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Phacoemulsification combined with goniosynechialysis (GSL) in primary angle closure (PAC) and primary angle closure glaucoma (PACG) patients

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Session Details

Session Title: Special Cases
Session Date/Time: Friday 26/02/2016 | 08:30-10:00
Paper Time: 08:30
Venue: MC3 Room
First Author: : P.Chiam UK
Co Author(s): :    V. Sung              

Abstract Details


The primary aim was to evaluate the effect of phacoemulsification and GSL on the intraocular pressure (IOP) in patients with PAC or PACG. The secondary aim was to assess any adverse event of such procedure.


Birmingham and Midland Eye Centre, United Kingdom


This was a retrospective study. Patients with peripheral anterior synechiae (PAS) confirmed on gonioscopy who had uneventful phacoemulsification and at least 180 degree GSL were included. The patients were paired with ocular hypertensive (OHT) patients within 10 years of age and pre-operative IOP within 3mmHg undergoing phacoemulsification without GSL. The percentage of IOP change at 3 to 6 month post-operation was compared. The pre- and post-operative number of anti-glaucoma medications was also evaluated.


Thirteen patients (13 eyes) with PAC/PACG underwent uncomplicated phacoemulsification and GSL. These were paired with 13 OHT patients (13 eyes) who had the uneventful phacoemulsification only. There was no difference between the pre-operative IOPs - 24.2mmHg in PAC/PACG and 23.8mmHg in OHT (p=0.17). Post-operatively, the IOPs were 15.7mmHg and 19.4mmHg in each group (p=0.001). These constituted a reduction of 35% and 18% from pre-operative IOPs respectively. The PAC/PACG group was on an average of 2.6 anti-glaucoma eye drops, which was reduced to 0.9 post-operatively. No patients had prolonged post-operative uveitis or any other adverse events.


Phacoemulsification combined with goniosynechialysis (GSL) is an effective and safe way to reduce the IOP in primary angle closure and primary angle closure glaucoma patients.

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