Surgical management of medically uncontrolled synechial angle-closure Glaucoma: Lensectomy with or without Goniosynechialysis
European Journal of Ophthalmology, cilt.36, sa.4, ss.943-953, 2026 (SCI-Expanded, Scopus)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 36 Sayı: 4
- Basım Tarihi: 2026
- Doi Numarası: 10.1177/11206721261425698
- Dergi Adı: European Journal of Ophthalmology
- Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, EMBASE, MEDLINE, Biomedical Reference Collection: Corporate Edition (EBSCO)
- Sayfa Sayıları: ss.943-953
- Anahtar Kelimeler: Angle closure, chronic angle-closure glaucoma, Goniosynechialysis, Lensectomy, Lensectomy combined with goniosynechialysis, peripheral anterior synechia
- Sağlık Bilimleri Üniversitesi Adresli: Evet
Özet
Purpose: To investigate the efficacy of lensectomy (LE) and the role of additional goniosynechialysis (LE-GSL) in eyes with medically uncontrolled synechial angle-closure glaucoma (ACG). Methods: The records of patients who underwent LE or LE-GSL for >180° synechial ACG were reviewed retrospectively. Three groups were formed based on intraoperative gonioscopy (IOG) findings following lensectomy and intraocular lens implantation: Group 1 (n = 39), eyes with total peripheral anterior synechiae (PAS) in which GSL was performed; Group 2 (n = 37), eyes with PAS ≥ 180° and <360° in which GSL was performed; and Group 3 (n = 35), eyes with PAS < 180° in which no GSL was performed. Results: A total of 111 eyes of 98 patients (M/F: 46/52; mean age: 60.1 ± 11.01 years) were included in the study. Median postoperative follow-up time was 12.0 months. Median PAS extents in the three groups were 12, 6, and 0 clock hours (CH) on IOG, compared to 12, 10, and 7 CH before surgery. GSL was performed in Groups 1 and 2, with a median of 11 and 4 CH. Median IOP at the final visit was 14 mmHg in all three groups. Total success rates were 87%, 81%, and 97% in Groups 1, 2, and 3, respectively (p = 0.102). Conclusion: The present study identified discrete groups of patients who would benefit from LE alone versus needing further GSL in synechial ACG. When PAS was <180° on IOG, LE alone effectively reduced IOP; in eyes with extensive PAS, performing additional GSL yielded successful results, comparable to eyes undergoing LE alone.