Efficacy and Safety of Surgical Peripheral Iridectomy, Goniosynechialysis, and Goniotomy for Advanced Primary Angle Closure Glaucoma Without Cataract: 1-Year Results of a Multicenter Study

作者：Xinbo Gao, Fengbin Lin, Ping Lu, Lin Xie, Li Tang, Xiaomin Zhu, Yao Zhang, Aiguo Lv, Guangxian Tang, Hengli Zhang, Xiaowei Yan, Yunhe Song, Jiangang Xu, Jingjing Huang, Yingzhe Zhang, Kun Hu, Yu-Ying Peng, Zhenyu Wang, Xiaoyan Li, Weirong Chen, Ningli Wang, Keith Barton, Ki Ho Park, Tin Aung, Robert N. Weinreb, Dennis S.C. Lam, Sujie Fan, Clement C. Tham, Xiulan Zhang, for the TVG study group · 发表于：Journal of Glaucoma · 年份：2024 · DOI：10.1097/ijg.0000000000002443 · 被引用次数：11 · 研究领域：Glaucoma and retinal disorders、Ophthalmology and Eye Disorders、Ocular Disorders and Treatments

PRÉCIS: The combination of surgical peripheral iridectomy, goniosynechialysis, and goniotomy is a safe and effective surgical approach for advanced primary angle closure glaucoma without cataract. PURPOSE: To evaluate the efficacy and safety of surgical peripheral iridectomy (SPI), goniosynechialysis (GSL), and goniotomy (GT) in advanced primary angle closure glaucoma (PACG) eyes without cataract. PATIENTS AND METHODS: A prospective multicenter observational study was performed for patients who underwent combined SPI, GSL, and GT for advanced PACG without cataract. Patients were assessed before and after the operation. Complete success was defined as achieving intraocular pressure (IOP) between 6 and 18 mm Hg with at least a 20% reduction compared with baseline, without the use of ocular hypotensive medications or reoperation. Qualified success adopted the same criteria but allowed medication use. Factors associated with surgical success were analyzed using logistic regression. RESULTS: A total of 61 eyes of 50 advanced PACGs were included. All participants completed 12 months of follow-up. Thirty-six eyes (59.0%) achieved complete success, and 56 eyes (91.8%) achieved qualified success. Preoperative and postsurgical at 12 months mean IOPs were 29.7±7.7 and 16.1±4.8 mm Hg, respectively. The average number of ocular hypotensive medications decreased from 1.9 to 0.9 over 12 months. The primary complications included IOP spike (n=9), hyphema (n=7), and shallow anterior chamber (...