Long-Term Effects of Phacoemulsification with Goniosynechialysis in Angle-Closure Glaucoma: A 2-Year Prospective Cohort Study.

INTRODUCTION

The aim of this study was to compare long-term effect of phacoemulsification combined with goniosynechialysis (Phaco-GSL) in patients with acute primary angle-closure glaucoma (APACG) and those with chronic primary angle-closure glaucoma (CPACG), and to evaluate the influencing factors of the surgical prognosis.

METHODS

In this prospective cohort study, patients with APACG or CPACG who underwent Phaco-GSL at the glaucoma clinics of Eye and ear, nose, and throat (ENT) Hospital were recruited consecutively from January 2019 to December 2022. Standardized 2-year follow-ups assessed baseline characteristics and surgical outcomes. The cumulative success rates and influencing factors of surgical prognosis were analyzed.

RESULTS

A total of 213 patients were enrolled, including 116 patients (116 eyes) with APACG and 97 patients (97 eyes) with CPACG. The average age was 64.5 ± 7.2 years and 153 (71.8%) patients were women. The complete success rates at 2 years were 72.4% in the acute group and 65.0% in the chronic group (P = 0.04). The qualified success rates at 2 years were 81.9% in the acute group and 81.4% in the chronic group (P = 0.44). Baseline mean deviation, anterior chamber depth (ACD), and glaucoma type were identified as independent predictors of surgical outcomes in the overall cohort. In subgroup analyses, a longer duration of elevated intraocular pressure showed a trend toward poorer surgical prognosis in acute PACG, whereas shallower ACD was associated with poorer outcomes in chronic PACG.

CONCLUSIONS

Phaco-GSL demonstrated significant benefits for both APACG and CPACG, with more pronounced effects for APACG. Identifying patients with prognostic factors preoperatively provides valuable insights for better assessing the outcomes of GSL surgery in PACG.