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Phaco with goniosynechiolysis may be option for angle closure

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Phacoemulsification with goniosynechiolysis may be an effective treatment option for primary angle closure that has been unresponsive to conventional therapy, according to a study.

Paul J. Harasymowycz, MD, and colleagues reviewed the charts of 21 patients with primary angle closure who did not respond to medical management, Nd:YAG peripheral iridotomy or argon laser peripheral iridoplasty. The average patient age was 65.6 years. The underlying mechanism of angle closure was pupillary block in 18 patients and plateau iris in three patients. The average IOP before phaco and goniosynechiolysis was 40.7 mm Hg. Mean IOP decreased by 25 mm Hg after the treatment. Average follow-up time after the procedure was 11.7 months. The mean number of medications patients took was reduced by more than half after the surgery, from 3.8 to 1.7. Subsequent trabeculectomy was necessary for one patient.

The study is published in the June issue of Journal of Glaucoma.