Efficacy and safety of inferior 180 degrees goniosynechialysis followed by diode laser peripheral iridoplasty in the treatment of chronic angle-closure glaucoma.
OBJECTIVE
To report the efficacy and safety of inferior 180 degrees goniosynechialysis followed by diode laser peripheral iridoplasty in the treatment of chronic angle-closure glaucoma with total synechial angle closure.


METHODS
Five patients with chronic angle-closure glaucoma and total synechial angle closure whose intraocular pressures were higher than 21 mm Hg while taking maximally tolerated medications underwent goniosynechialysis followed by diode laser peripheral iridoplasty to the inferior half of the angle. Intraoperative complications, postoperative visual acuity, intraocular pressures, and complications were evaluated.


RESULTS
Five eyes of five patients received the operation and the mean follow-up was 7.6 months (range, 6-12 months). The mean preoperative intraocular pressure was 33.8 +/- 5.8 mm Hg. The mean postoperative intraocular pressure at most recent follow-up was 15.8 +/- 2.2 mm Hg. Postoperative complications included transient increase in intraocular pressure, hyphema, and cataract. The success rate (intraocular pressure less than 20 mm Hg with or without medication) was 80.0%.


CONCLUSIONS
It appears that 180 degrees goniosynechialysis followed by diode laser peripheral iridoplasty is an effective and safe surgical procedure for treating chronic angle-closure glaucoma with total synechial angle closure.
Lai
J S
JS
Department of Ophthalmology, United Christian Hospital, Kwun Tong, Kowloon, Hong Kong.
Tham
C C
CC
Chua
J K
JK
Lam
D S
DS
D000368:Aged; D000369:Aged, 80 and over; D002908:Chronic Disease; D005260:Female; D015812:Glaucoma, Angle-Closure / Q000601:surgery*; D006801:Humans; D007429:Intraocular Pressure; D007431:Intraoperative Complications; D007498:Iris / Q000601:surgery*; D053685:Laser Therapy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D013508:Ophthalmologic Surgical Procedures; D011183:Postoperative Complications; D011446:Prospective Studies; D012449:Safety; D016896:Treatment Outcome; D014792:Visual Acuity