关键词: 原发性闭角型青光眼, 房角分离术, 晶状体摘除, 微创青光眼手术

Abstract: The concept of goniosynechialysis (GSL) was described a half century ago. It was difficult to perform due to technically anterior chamber collapse at the beginning and later good clinical efficacy was obtained with viscoelastic maintaining anterior chamber and  irrigating cyclodialysis spatula combined with peripheral iridectomy to eliminate the pupillary block. Modern therapeutic system of GSL was developed based on the former research experiences, the procedures including, crystalline lens extraction, intraocular lens implantation combined with direct view under goniolens or endoscope. Modern therapeutic system of GSL has currently become the main effective method for primary angle-closure glaucoma (PACG). It’s advantages include quick, less invasive, bleb independent, restoring physiological drainage rout of aqueous humor. Recently, minimally invasive glaucoma surgery (MIGS) were also applied in the treatment of PACG, for example, partial goniotomy (GT) or ab interno trabeculectomy (Kahook Dual Blade, KDB) was added to the modern GSL system (GSLplus) for PACG, thereby the therapeutical effect of PACG was improved and more alternatives were provided, and has excited application potential. This article reviews the history, mechanism, modern procedures , clinical efficacy, concerned issues and the future trend of GSL. (Int Rev Ophthalmol, 2023, 47: 244-249)

Key words: primary angle-closure glaucoma, goniosynechialysis, lens extraction, minimally invasive glaucoma surgery