Emmanuel Eric Pazo

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Phaco-goniosynechialysis versus phaco-trabeculectomy in patients with refractory primary angle-closure glaucoma: a comparative study

Jiahui Zhao, Chenguang Zhang, Emmanuel Eric Pazo, Guangzheng Dai, Yunyan Li, Yimeng Chen, Mingze Li, Huixin Che

BMC Ophthalmology, 2023 · article · doi:10.1186/s12886-023-02885-6 · cited by 16 · Open access (CC BY)

Cataract & anterior segment surgery

Abstract

PURPOSE: To compare the effects of phacoemulsification with intraocular lens implantation (phaco) combined with goniosynechialysis (phaco + GSL) versus phaco with trabeculectomy (phaco + trab) for the management of primary angle-closure glaucoma (PACG) refractory to peripheral anterior synechiae (PAS) of over 180°. METHODS: This retrospective study followed 77 eyes of 77 patients for at least 6 months. Intraocular pressure (IOP), best-corrected visual acuity (BCVA), number of glaucoma drugs, and PAS were recorded at the preoperative baseline and evaluated at each postoperative follow-up visit. The National Eye Institute Visual Functioning Questionnaire-25 (NEI VFQ-25) was administered to patients enrolled in this study. Pearson's correlation analysis and multivariate linear analysis were performed to identify factors influencing changes in NEI VFQ-25 scores and to identify factors associated with increases in NEI VFQ-25 scores after the operation. RESULTS: In total, seventy-seven eyes were included (43 with phaco + GSL and 34 with phaco + trab). Comparing preoperative baseline and month 6 after surgery measurements revealed that both groups found significant improvements in IOP, PAS, BCVA and the number of glaucoma drugs (P < 0.05). Baseline NEI VFQ-25 scores were similar in the two groups, but there was a significant difference in postoperative NEI VFQ-25 scores (74.47 ± 10.39 in phaco + GSL vs. 69.57 ± 8.54 in phaco + trab, P = 0.048 < 0.05), and the phaco + GSL group had better scores at the time of the last follow-up. The change in preoperative scores and the number of glaucoma drugs was significantly correlated with postoperative scores in the phaco + GSL group. CONCLUSION: Phaco + GSL treatment is as safe and effective as phaco + trab for refractory PACG patients, and patients' subjective experience improved significantly after phaco + GSL surgery.

Keywords: primary angle-closure glaucoma; refractory glaucoma; phacoemulsification; goniosynechialysis; trabeculectomy; peripheral anterior synechiae; intraocular pressure; visual function

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How to cite

Zhao, J., Zhang, C., Pazo, E. E., Dai, G., Li, Y., Chen, Y., Li, M., Che, H. (2023). Phaco-goniosynechialysis versus phaco-trabeculectomy in patients with refractory primary angle-closure glaucoma: a comparative study. BMC Ophthalmology. https://doi.org/10.1186/s12886-023-02885-6

@article{zhao2023phaco,
  title = {{Phaco-goniosynechialysis versus phaco-trabeculectomy in patients with refractory primary angle-closure glaucoma: a comparative study}},
  author = {Zhao, Jiahui and Zhang, Chenguang and Pazo, Emmanuel Eric and Dai, Guangzheng and Li, Yunyan and Chen, Yimeng and Li, Mingze and Che, Huixin},
  journal = {BMC Ophthalmology},
  year = {2023},
  doi = {10.1186/s12886-023-02885-6},
  url = {https://doi.org/10.1186/s12886-023-02885-6},
}

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