Clinical Case Report - Case report on the efficacy of phacoemulsification combined with goniosynechialysis in the treatment of advanced primary angle-closure glaucoma complicated with cataract

Sep 30, 2026

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Primary angle-closure glaucoma (PACG) is a major cause of irreversible blindness, and many patients present with advanced disease, especially when cataract coexists. A retrospective case analysis evaluated PACG patients treated at Shanxi Provincial Eye Hospital with phacoemulsification and intraocular lens implantation combined with goniosynechialysis (PEI + GSL) between June 1 and October 1, 2023. Visual acuity, intraocular pressure, antiglaucoma medications, and complications were followed over 1 week, 1 month, 3 months, and 6 months, showing reduced IOP and improved outcomes after surgery.

LanguageEnglish

CategoryHealthcare

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Abstract

1. Introduction

2. Methods

® Clinical Case Report Case report on the efficacy of phacoemulsification combined with goniosynechialysis in the treatment of advanced primary angle-closure glaucoma complicated with cataract Qi Wang, MMa , Junmei Zhao, MMa ,* | Abstract
Rationale: Primary angle-closure glaucoma (PACG) is a leading cause of irreversible blindness in China, with a prevalence of as high as 1.5% in individuals over 50 years of age. Many patients are already at an advanced stage of the disease at their first clinical presentation.
Patient concerns: A retrospective analysis was performed on PACG patients who underwent PEL + GSL at Shanxi Provincial Eye Hospital from June 1, 2023, to October 1, 2023.The patient noticed a decline in their vision, a narrowing of the visual field, accompanied by discomfort such as eye distension and redness. Preoperative biometry, visual field, and (Ultrasound Biomicroscopy) UBM results were recorded, and observations were made before surgery. Visual acuity, intraocular pressure, antiglaucoma medication and complications were recorded at 1week, 1month, 3months, and 6 months.
Diagnoses: All eyes had advanced PACG, with an average mean deviation of-25.243 ± 6.550 dB and a pattern standard deviation of 6.516 ± 3.042. 48 cases (56 eyes) were collected, ranging in age from 47 to 86 (66 .62 ± 9. 10) years, and 32 (66 .66%) were female patients. The preoperative visual acuity was 0.375 ± 0.245, the average mean deviation of the visual field was −25.04 ± 5.59 dB, and the pattern standard deviation was 6.516 ± 3.042.
Interventions: All patients successfully underwent cataract surgery combined with goniosynechialysis.
Outcomes: The intraocular pressure after PEL + GSL dropped from 27.84 ± 11.47 mm Hg before surgery to 13.696 ± 1.69 mm Hg at the last follow-up, the visual acuity improved from 0.375 ± 0.245 before surgery to 0.529 ± 0.210, and the antiglaucoma drugs decreased from 2.52 ± 0.50 before surgery to 0.11 ± 0.37.
Lessons: PEL + GSL is an effective method for the treatment of advanced PACG combined with cataract, which can significantly reduce intraocular pressure with few complications.
Abbreviations: ACD = anterior chamber depth, AL = axial length, BCVA = best-corrected visual acuity, C/D = cup-to-disc, EGSL = endoscopic goniosynechialysis, GSL = goniosynechialysis, IOP = intraocular pressure, logMAR = logarithm of the minimum angle of resolution, LT = lens thickness, MD = mean deviation, PACG = primary angle-closure glaucoma, PAS = peripheral anterior synechiae, PEI = phacoemulsification and intraocular lens implantation, PSD = pattern standard deviation, UBM = ultrasound biomicroscopy. | | --- | | Keywords: goniolysis, intraocular pressure, Primary chronic angle-closure glaucoma | 1. Introduction Advanced primary angle-closure glaucoma (PACG) with cataract poses a significant threat to vision and remains a challenging clinical condition. For this type of patient, trabeculectomy is the traditional treatment method. Recently, cataract surgery (phacoemulsification and intraocular lens implantation, PEI) combined with goniosynechialysis (GSL) (PEI + GSL) has been widely adopted for PACG management. [1–5] However, no studies have analyzed its efficacy in advanced-stage glaucoma This study was supported by the Shanxi Eye Hospital Youth Fund Project in 2021 (Q202103). The authors have no conflicts of interest to disclose. All data generated or analyzed during this study are included in this published article [and its supplementary information files]. This study was approved by the Ethics Committee of Shanxi Eye Hospital. The views and opinions expressed in this article are those of the authors and do not necessarily reflect the official policy or position of the publisher or any institution with which the authors are affiliated. a Department of Glaucoma, Shanxi Eye Hospital, Taiyuan, China. * Correspondence: Junmei Zhao, Department of Glaucoma, Shanxi Eye Hospital, Taiyuan 03

FAQs

What patient population and study period were included in this case report?

The report retrospectively analyzed PACG patients who underwent PEI + GSL at Shanxi Provincial Eye Hospital from June 1, 2023, to October 1, 2023.

What interventions were performed for the patients in this study?

All patients successfully underwent cataract surgery combined with goniosynechialysis (phacoemulsification and intraocular lens implantation plus GSL).

What were the key outcome changes after PEI + GSL?

Intraocular pressure decreased from 27.84 ± 11.47 mm Hg preoperatively to 13.696 ± 1.69 mm Hg at the last follow-up, visual acuity improved, and antiglaucoma drug use decreased.

Sep 30, 2026

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