J Korean Ophthalmol Soc.  2015 Jun;56(6):931-937. 10.3341/jkos.2015.56.6.931.

Combined Phacoemulsification, Synechiolysis without Gonioprism Lens and Intracameral Tissue Plasminogen Activator Injection for Angle-Closure Glaucoma

• Cho SH
• Kee CW

• KMID: 2339160
• DOI: http://doi.org/10.3341/jkos.2015.56.6.931

Abstract

PURPOSE
In this study we evaluated the safety and efficacy of combined phacoemulsification and synechiolysis without aid of gonioprism lens and intraoperative intracameral tissue plasminogen activator (tPA) injection for angle-closure glaucoma.
METHODS
The method used in this study was synechiolysis with Kuglen hook without aid of gonioprism lens and intraoperative intracameral tPA injection following cataract surgery.
RESULTS
A total of 20 patients with a mean age of 71.4 +/- 5.4 years were treated. Mean follow-up time was 31.3 +/- 24.3 months. Mean preoperative and last visit intraocular pressures (IOPs) were 21.70 +/- 9.50 mm Hg and 12.40 +/- 2.30 mm Hg, respectively (p < 0.0001). The mean number of glaucoma medications decreased from 2.40 to 0.30 (p < 0.0001). IOP was maintained below 16 mm Hg in all cases. No significant intraoperative and postoperative complications, hyphema, or fibrin reaction occurred.
CONCLUSIONS
Combined phacoemulsification and peripheral anterior synechiolysis with Kuglen hook without aid of gonioprism lens and intraoperative intracameral tPA injection is an effective and safe surgical procedure.

Keyword

Angle-closure glaucoma; Fibrin reaction; Synechiolysis; Tissue plasminogen activator

MeSH Terms

Cataract
Fibrin
Follow-Up Studies
Glaucoma
Glaucoma, Angle-Closure*
Humans
Hyphema
Intraocular Pressure
Phacoemulsification*
Postoperative Complications
Tissue Plasminogen Activator*
Fibrin
Tissue Plasminogen Activator

Figure

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  Figure 1. The sequential images during synechialysis.

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  Figure 2. Baseline and postoperative intraocular pressure (IOP) trend.

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  Figure 3. Compared with preoperative anterior segment optical coherence tomography (OCT) image (A), postoperative image (B) showing deepening of anterior chamber depth.

Reference

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