One-year outcomes of combined phacoemulsification and goniosynechialysis in primary angle-closure glaucoma with cataracts: a multicenter prospective study
This study aimed to observe the safety and effectiveness of combined phacoemulsification and goniosynechialysis (PEI-GSL) in patients with primary angle-closure glaucoma (PACG) and coexisting cataracts. This multicenter prospective study enrolled 289 consecutive patients with PACG and cataracts who were treated using PEI-GSL between November 1, 2022 and March 12, 2024. All patients underwent comprehensive ocular evaluations at baseline, at 1 week, and at 1, 3, 6, and 12 months postoperatively. Complete success was defined as achieving an intraocular pressure (IOP) of 6–18 mmHg without antiglaucoma medications or reoperation. Qualified success was similarly defined but allowed antiglaucoma medications. Among patients with PACG, 237 (82.0%) of 289 completed a 12-month follow-up. The baseline IOP decreased from 22.9 ± 10.2 to 14.0 ± 3.1 mmHg at 12 months, and the number of antiglaucoma medications declined from 2.08 ± 1.23 to 0.14 ± 0.52. The complete and qualified success rates were 80.6% and 88.3%, respectively. Postoperative complications occurred in 49 (17.0%) patients; while 3 (1.0%) patients underwent yttrium-aluminum-garnet (YAG) laser capsulotomy and 6 (2.1%) required glaucoma surgery. Multivariate Cox regression analysis revealed that the anterior chamber depth (P = 0.044) and axial length (P = 0.050) were positively associated with qualified success. The complete and qualified success rates among patients with advanced PACG were 78.2% and 87.9%, respectively. We demonstrated that PEI-GSL is an effective and safe treatment for patients with PACG and coexisting cataracts, even in advanced stages.