Ophthalmology in China ›› 2024, Vol. 33 ›› Issue (5): 337-343.doi: 10.13281/j.cnki.issn.1004-4469.2024.05.003

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Clinical analysis of reoperation after phacoemulsification combined with goniosynechialysis for primary angle-closure glaucoma

Lin Haishuang1, Wang Xiaojie2, 3, Li Jiaqian1, Ji Yiting1, Ding Yutong1, Zheng Xuanli1, Wan Rui1, Zhang Shaodan2, 3, 4, Li Guoxing2, 3, 4, Liang Yuanbo2, 3, 4, Wang Ningli3, 5   

  1. 1 Wenzhou Medical University, Wenzhou Zhejiang 325027, China; 2 The Eye Hospital, School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou Zhejiang 325027, China; 3 National Clinical Research Center for Ocular Diseases, Wenzhou Zhejiang 325027, China; 4 Glaucoma Research Institute, Wenzhou Medical University, Wenzhou Zhejiang 325027, China; 5 Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Key Laboratory of Ophthalmology and Visual Sciences, Beijing 100730, China
  • Received:2024-07-19 Online:2024-09-25 Published:2024-08-28
  • Contact: Liang Yuanbo, Email: yuanboliang@wmu.edu.cn
  • Supported by:
    Program for Zhejiang Leading Talent of S&T Innovation (2021R52012); Key Research and Development Projects of Zhejiang Province (2022C03112); Zhejiang Provincial Program for the Cultivation of Leading Talents in Colleges and Universities (2020099)


Abstract:  Objective To investigate the causes and clinical characteristics of reoperation after phacoemulsification combined with intraocular lens implantation plus goniosynechialysis (PEI-GSL) for primary angle-closure glaucoma (PACG). Design Retrospective case series. Participants 1241 patients (1461 eyes) with PACG who underwent PEI-GSL in the Eye Hospital of Wenzhou from January 1, 2018 to December 31, 2021. Methods The patients' medical records were reviewed to analyze their clinical characteristics, type of reoperation, and reasons for reoperation. Main Outcome Measures  Causes and clinical features of reoperation after PEI-GSL in patients with PACG. Results A total of 1241 PACG patients (1461 eyes) received PEI-GSL during the study period, including 17 patients (19 eyes) who received unplanned reoperation, with an incidence of 1.3%. Uncontrolled intraocular pressure was the main reason for reoperation, accounting for 73.7%. The complications such as residual lens cortex (5.3%), iris incarceration in corneal incision (5.3%), bag collapse (5.3%), deviation of intraocular lens (5.3%) and dilated pupil (5.3%) were the other reasons. The reason for uncontrolled intraocular pressure after PEI-GSL include early angle closure (9 eyes, 64.2%), late angle closure (3 eyes, 21.4%) and trabecular meshwork dysfunction (2 eyes, 14.3%). All patients with early angle closure were women. Among them, 6 eyes were CACG (66.7%), the median outset of uncontrolled intraocular pressure after PEI-GSL was 16 (1, 46.5) days (range: 1~60 days), the average range of anterior chamber angle synechiae before reoperation was (308.3±34.0) ° (range: 240°~360 °), the average central anterior chamber depth was (2.4±0.4) mm (range: 1.7~3.1 mm), and 71.4% of patients had myopia drift. Conclusion The main reason for reoperation after PEI-GSL was uncontrolled intraocular pressure. Patients with early angle closure after PEI-GSL surgery may have anterior displacement of intraocular lens. (Ophthalmol CHN, 2024, 33: 337-343)

Key words: primary angle closure glaucoma, goniosynechialysis, phacoemulsification, uncontrolled intraocular pressure