Clinical ophthalmology (Auckland, N.Z.) · 2026
The Adjunctive Effect of Goniotomy Combined with Phacoemulsification and Goniosynechialysis for Advanced Primary Angle-Closure Glaucoma with 360° Angle Closure: 12-Month Outcomes.
СтатьяНазвание и аннотация: Перевод пока не подготовлен
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Zhang Yuqiao, Dong Wenhui, Zhao Suwen, Lai Chunxin, Lin Hongliang, Liu Xiaoyan, Zeng Li, Li Yuxuan, Wang Di, Zhang Hongyang
Аннотация
PURPOSE: To compare phacoemulsification with intraocular lens implantation and goniosynechialysis, with or without adjunctive goniotomy, in advanced primary angle-closure glaucoma with complete circumferential angle closure.
DESIGN: Retrospective comparative study.
METHODS: This study included 61 eyes undergoing phacoemulsification and goniosynechialysis without (N=31) or with adjunctive goniotomy (N=30), with at least 12 months of follow-up. A peripheral anterior synechiae of 360° was confirmed by gonioscopy and ultrasound biomicroscopy. The primary outcome was month-12 intraocular pressure (IOP). Longitudinal generalized estimating equations adjusted for baseline IOP, age, sex, and vertical cup-to-disc ratio. Secondary outcomes included medication use, surgical success, postoperative angle status, and complications.
RESULTS: At month 12, mean IOP was 16.26 ± 3.03 mmHg in the group without goniotomy and 16.63 ± 3.29 mmHg in the group with goniotomy. The adjusted between-group difference was -0.46 mmHg (95% CI -1.97 to 1.04, P=0.54), below the post hoc exploratory margins of 4, 3, and 2 mmHg. Medication use had no significant difference between groups (P=0.89). Complete and qualified success rates were similar at IOP thresholds of ≤21, ≤18, and ≤15 mmHg combined with at least 20% IOP reduction, with comparable cumulative success rate. Hyphema occurred in 1/31 eyes (3.2%) and 9/30 eyes (30.0%) in groups without and with adjunctive goniotomy (absolute risk difference, 26.8 percentage points, 95% CI, 7.7 to 45.8, P<0.01).
CONCLUSIONS: In advanced PACG eyes with 360° angle closure, the differences between the 12-month IOP control, surgical success, and medication reduction of the two groups showed no statistically significance. Routine addition of goniotomy may not provide additional benefit.
DESIGN: Retrospective comparative study.
METHODS: This study included 61 eyes undergoing phacoemulsification and goniosynechialysis without (N=31) or with adjunctive goniotomy (N=30), with at least 12 months of follow-up. A peripheral anterior synechiae of 360° was confirmed by gonioscopy and ultrasound biomicroscopy. The primary outcome was month-12 intraocular pressure (IOP). Longitudinal generalized estimating equations adjusted for baseline IOP, age, sex, and vertical cup-to-disc ratio. Secondary outcomes included medication use, surgical success, postoperative angle status, and complications.
RESULTS: At month 12, mean IOP was 16.26 ± 3.03 mmHg in the group without goniotomy and 16.63 ± 3.29 mmHg in the group with goniotomy. The adjusted between-group difference was -0.46 mmHg (95% CI -1.97 to 1.04, P=0.54), below the post hoc exploratory margins of 4, 3, and 2 mmHg. Medication use had no significant difference between groups (P=0.89). Complete and qualified success rates were similar at IOP thresholds of ≤21, ≤18, and ≤15 mmHg combined with at least 20% IOP reduction, with comparable cumulative success rate. Hyphema occurred in 1/31 eyes (3.2%) and 9/30 eyes (30.0%) in groups without and with adjunctive goniotomy (absolute risk difference, 26.8 percentage points, 95% CI, 7.7 to 45.8, P<0.01).
CONCLUSIONS: In advanced PACG eyes with 360° angle closure, the differences between the 12-month IOP control, surgical success, and medication reduction of the two groups showed no statistically significance. Routine addition of goniotomy may not provide additional benefit.