Primary Outcomes of Patients with Chronic Angle-Closure Glaucoma Treated with Combined Phacoemulsification, Viscogoniosynechialysis, and Endocyclophotocoagulation

PURPOSE/OBJECTIVE: To evaluate the effectiveness of combined phacoemulsification, viscogoniosynechialysis (VGSL), and endocyclophotocoagulation (ECP) in patients with moderate chronic angle-closure glaucoma (CACG) with peripheral anterior synechia (PAS) ≥90 not controlled with glaucoma medications and previous iridotomy yag laser. MATERIALS AND METHODS: We retrospectively reviewed records from patients with cataract and uncontrolled chronic angle-closure glaucoma despite maximal tolerated medical therapy and iridotomy yag laser who received combined treatment with phacoemulsification with posterior capsular lens implantation, VGSL, and ECP 360°. We evaluated intraocular pressure (IOP), glaucoma medications, and best corrected visual acuity (BCVA) preoperatively and during follow-up. RESULTS: A total of 29 eyes from 22 patients received surgical intervention. Mean follow-up was 6 months. Mean preoperative IOP was 18.2 mmHg, and postoperatively, IOP was 13.5, 12.2, and 12.8 mmHg at 1, 3, and 6 months, respectively. Complete success was 37.9%, and relative success was 72.4%. Mean BCVA was 0.4 logMAR preoperative and 0.3 logMAR 6 months after surgery. Glaucoma medication fell significantly from 2.34 ± 1.66 preoperatively to 1.31 ± 2.6 postoperatively (p < 0.001). Overall, 44.8% of the patients did not require glaucoma medications at 6 months. There were no visual significant complications. CONCLUSION: Combined treatment with phacoemulsification with posterior capsular lens implantation, VGSL, and ECP is effective and safe in reducing IOP and number of glaucoma medications with stable BCVA at 6 months.