Efficacy and Safety of Combined Phacoemulsification, Intraocular Lens Implantation, Goniosynechialysis, and Trabectome in Patients With Primary Angle-Closure Glaucoma

We evaluated the efficacy and safety of combined phacoemulsification, intraocular lens implantation, goniosynechialysis (GSL), and trabectome in patients with primary angle-closure glaucoma (PACG). In this prospective interventional study, twenty patients (22 eyes) of PACG treated with combined phacoemulsification, intraocular lens implantation, GSL, and trabectome between September 2017 to September 2020 were recruited. The intraocular pressure (IOP), the number of glaucoma medications, and best-corrected visual acuity (BCVA) were recorded at baseline, 1, 3, 6, 12, and 24 months after operation. IOP was decreased significantly from 20.69±6.90 mmHg at baseline to 15.83±2.79mmHg at 24 months’ follow-up (P=0.043). The number of glaucoma medications reduced from 2.76±1.14 preoperatively to 0.73±0.77 at 24 months’ follow-up (P=0.026). The qualified success rate was 86.8% at 2 years. The reduction of IOP showed a positive correlation with baseline IOP (p<0.001) and the reduction of the number of glaucoma medications was positively correlated with baseline number of glaucoma medications (p<0.001). There was no vision-threatening complication during and after operation. The combined procedure of phacoemulsification, IOL implantation, GSL, and trabectome was effective and safe for PACG patients. It may provide a new method for PACG patients especially those with long term and extensive goniosynechia.