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A randomised controlled study comparing phacoemulsification alone vs phacoemulsification with goniosynechialysis in patients with primary angle-closure disease

Poster Details

First Author: R.Husain SINGAPORE

Co Author(s):    D. Tan   J. Lai   N. Kitnarong   M. Nongpiur   S. Lim   T. Aung     

Abstract Details


To compare phacoemulsification with intraocular lens implantation alone (PEI) to PEI with goniosynechialysis (PEI-GSL) to see which procedure results in better intraocular pressure control at one year.


Singapore National Eye Centre Vietnam National Institute of Ophthalmology Siriraj Hospital, Mahidol Thailand University, Thailand Queen Mary Hospital, Hong Kong


In this international multicentre randomised controlled trial we recruited patients with primary angle closure disease (PACD) and at least 90 degrees of peripheral anterior synechiae (PAS). They were randomized to undergo PEI or PEI-GSL. Primary outcome was successful control of IOP at 12 months, defined as IOP ≤21mmHg without topical IOP lowering medications and a decrease in IOP of ≥ 20% of baseline IOP.


At 12 months, 35 patients in the PEI group, and 33 patients in the PEI-GSL group completed follow up. Success at 1 year occurred in 21 (52.5%) in the PEI group and in 22 (57.9%) in the PEI-GSL group (p=0.63). In eyes that achieved success, mean ± SD IOP (mmHg) at 1 year for the PEI and PEI-GSL groups respectively was 12.5±2.7 (range 7.0-19.0) and 13.6±2.4 (range 9.0-18.0). Medications at baseline and 1 year decreased from 2.2 ± 0.8 to 0.5 ± 0.9 in the PEI group and 1.9 ± 0.9 to 0.6± 1.2 in the PEI-GSL group (p<0.001).


For patients with PACD and PAS, both PEI and PEI-GSL result in a significant decrease in IOP and number of medications at one year. Goniosynechialysis does not result in additional IOP lowering compared to PEI alone.

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