Microcoaxial Phacoemulsification Combined With Viscogoniosynechialysis for Patients With Refractory Acute Angle-closure Glaucoma

Zhang, Xinyuan; Chen, Min; Yin, Jianwei; Yao, Ke

doi:10.1097/ijg.0b013e318268518d

Cited by 8 publications

(9 citation statements)

References 25 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The shallow anterior chamber depth is a common feature of glaucoma patients [11]. PAACG patients benefit a lot from the combined procedure of phacoemulsification and viscogoniosynechialysis, which deal with cataract problem and expand the anterior chamber depth to reduce the patients' suddenly increased IOP at the same time [12]. This study aimed to investigate the structure and vessel changes of the RNFL of PAACG eyes from patients suffering from different attack times.…”

Section: Introductionmentioning

confidence: 99%

Measurement of Retinal Changes in Primary Acute Angle Closure Glaucoma under Different Durations of Symptoms

Zhu

Zeng

et al. 2019

Journal of Ophthalmology

View full text Add to dashboard Cite

Purpose To investigate the changes of retinal nerve fiber layer (RNFL) in patients after an attack of primary acute angle closure glaucoma (PAACG) and to assess the impact of attack time on prognosis of retinal changes. Design cross-sectional study. Methods Twenty-six patients with unilateral PAACG attack and cataracts from 2017 to 2019 were enrolled. Eyes with PAACG attack time less than 1 day constituted the group A (n = 13), while eyes with PAACG attack time more than 1 day constituted the group B (n = 13). All patients received phacoemulsification and viscogoniosynechialysis after intraocular pressure (IOP) lowering. All patients underwent ophthalmic examinations including IOP, best-corrected visual acuity (BCVA), and visual field (VF). Optical coherence tomography angiography (OCTA) was used to obtain circumpapillary RNFL vessel density (cpVD). Spectral domain optical coherence tomography (SD-OCT) was used to examine the peripapillary RNFL and macular ganglion cell complex (GCC). All patients accepted 2 assessments before and 1 month after the procedure. Results The IOP of all patients recovered to normal (12.77 ± 2.65 mm Hgvs. 12.77 ± 3.85 mmHg, p=0.834) after the procedure. Patients in the group A had better BCVA improvement than those in the group B (1.32 ± 0.84 vs. 0.50 ± 0.21, p=0.004), as well as better mean defect (MD) values from VF (−3.65 ± 2.54 vs −16.05 ± 5.99, p < 0.001). Compared with group B, patients in the group A had thicker macula (Fovea area: 255.00 ± 27.94 μm vs. 203.92 ± 59.73 μm, p=0.010), thicker GCC (82.62 ± 8.76 μm vs. 65.23 ± 18.56 μm, p=0.005), and thicker RNFL (105.08 ± 9.38 μm vs. 77.69 ± 20.23 μm, p < 0.001). Higher blood flow density in all-plexus peripapillary retina was observed in the group A eyes compared with group B (full sector: 0.56 ± 0.02 vs. 0.41 ± 0.07, p < 0.001). In both groups, the association between average RNFL thickness and cpVD as well as MD values and pattern standard deviation (PSD) values from VF was stronger (R2 = 0.58, 0.60, −0.54, respectively, all p < 0.001) than the association between GCC thickness and cpVD, as well as MD values and PSD values (R2 = 0.37, p=0.001; R2 = 0.37, p=0.001; R2 = −0.27, p=0.007). Conclusion Patients with attack time less than 1 day had better retinal thickness and all-plexus peripapillary retina blood flow density. Controlling the attack time could decrease retinal damage by PAACG.

show abstract

Section: Introductionmentioning

confidence: 99%

Measurement of Retinal Changes in Primary Acute Angle Closure Glaucoma under Different Durations of Symptoms

Zhu

Zeng

et al. 2019

Journal of Ophthalmology

View full text Add to dashboard Cite

show abstract

“…To avoid these sequelae, especially in the case of conditions that conventional management can't managed high IOP, timely lens extraction may play an indispensable role in IOP control and vision rescue [3,[5][6][7][8][9]11]. However, the investigators only described standard phaco procedure but ignored the management of intraoperative challenges such as intractable corneal edema and extremely shallow anterior chamber to increase the accessibility and safety of phaco-GSL [6][7][8][9][10]. In this study, timely primary tailored phaco-GSL was conducted in refractory high IOP APAC patients and promising outcomes were achieved.…”

Section: Discussionmentioning

confidence: 99%

“…However, LPI was not always performed in all patients due to corneal edema or mid-dilated unreactive pupil, and a large number of APAC eyes are medically unresponsive [3]. Thus, the term "refractory" had been de ned in previous studies as conditions that intraocular pressure (IOP) can't be managed with conventional approaches [6][7][8][9][10]. Despite increasing evidence-based studies demonstrating the e cacy of phacoemulsi cation (phaco) and goniosynechialysis (GSL; phaco-GSL) in patients with APAC [5,[7][8][9][10][11][12], this procedure remains a technical di culty in patients with APAC and high IOP for many surgeons due to various challenges such as intractable corneal edema, shallow anterior chamber, oppy iris, or unstable lens [3].…”

Section: Introductionmentioning

confidence: 99%

“…Thus, the term "refractory" had been de ned in previous studies as conditions that intraocular pressure (IOP) can't be managed with conventional approaches [6][7][8][9][10]. Despite increasing evidence-based studies demonstrating the e cacy of phacoemulsi cation (phaco) and goniosynechialysis (GSL; phaco-GSL) in patients with APAC [5,[7][8][9][10][11][12], this procedure remains a technical di culty in patients with APAC and high IOP for many surgeons due to various challenges such as intractable corneal edema, shallow anterior chamber, oppy iris, or unstable lens [3]. Moreover, operating in the setting of high IOP and concomitant in ammation may be associated with higher risk of intraoperative and postoperative complications such as posterior capsular rupture, suprachoroidal hemorrhage, and cornea decompensation [3,13].…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Efficacy and safety of primary tailored phacoemulsification combined with goniosynechialysis for refractory acute primary angle closure

Liu

Xiao

et al. 2023

Preprint

View full text Add to dashboard Cite

Purpose: To assess the safety, efficacy, and long-term clinical outcomes of primary tailored phacoemulsification (phaco) combined with goniosynechialysis (GSL; phaco-GSL) in refractory acute primary angle closure (APAC) eyes with uncontrolled high intraocular pressure (IOP). Methods: This retrospective case series comprised 51 eyes of 42 consecutive patients with refractory APAC and high IOP who were treated using primary tailored phaco-GSL at 3 hospitals in China, from 2014 to 2021. Preoperative and postoperative IOP, corrected distant visual acuity (CDVA), corneal endothelial cell density (CECD), intraoperative and postoperative complications were recorded. The safety, efficacy and subsequent long-term clinical outcomes were analyzed. Results: The mean CDVA (LogMAR) was improved from 1.67±0.94 preoperatively to 0.23±0.26 postoperatively (P <0.001). Preoperative CECD was 2309.39±541.03 cells/mm2 in 33 eyes and inaccessible in 18 eyes due to severe corneal edema; at the final follow-up, the mean CECD of all patients was 1823.50±533.40 cells/mm2 (P <0.001). The mean IOP decreased from 48.51±6.25 mmHg preoperatively to 15.66±2.27 mmHg at the final follow-up (P <0.001). Among 51 eyes, additional tailored procedures performed were corneal indentation in 42 eyes, epithelial debridement in 9 eyes, giant epithelial bullae view in 4 eyes, pars-plana fluid aspiration in 3 eyes, and secondary intraocular lens implantation in 7 eyes. The IOP of all eyes was well controlled eventually and 47 eyes (92.16%) were successfully treated by phaco-GSL alone. No significant intraoperative or postoperative complications were observed. Conclusions: Primary tailored phaco-GSL is a safe and effective surgical management strategy for patients with refractory APAC and high IOP.

show abstract

“…También se ha descrito su utilidad en el control de la PIO en 2 estudios prospectivos de series de casos de cierres angulares agudos refractarios al tratamiento convencional 78,111 .…”

Section: Cirugía Aislada De Cristalino En El Glaucoma Por Cierre Anguunclassified

Guía terapéutica del glaucoma crónico por cierre angular primario

Muñoz-Negrete

González-Martín-Moro

Casas-Llera

et al. 2015

Archivos de la Sociedad Española de Oftalmología

View full text Add to dashboard Cite

Microcoaxial Phacoemulsification Combined With Viscogoniosynechialysis for Patients With Refractory Acute Angle-closure Glaucoma

Abstract: Microcoaxial phacoemulsification combined with viscogoniosynechialysis is an effective and safe treatment for managing refractory AACG. Using a 2.2-mm incision caused less surgically induced astigmatism and also improved visual quality.

Cited by 8 publications

References 25 publications

Measurement of Retinal Changes in Primary Acute Angle Closure Glaucoma under Different Durations of Symptoms

Measurement of Retinal Changes in Primary Acute Angle Closure Glaucoma under Different Durations of Symptoms

Efficacy and safety of primary tailored phacoemulsification combined with goniosynechialysis for refractory acute primary angle closure

Guía terapéutica del glaucoma crónico por cierre angular primario

Contact Info

Product

Resources

About