Abstract：
CONCLUSIONS: The combination of phacoemulsification, goniosynechialysis and goniotomy is an effective treatment for primary angle closure glaucoma patients with cataract, and this is not linked to the extent of preoperative peripheral anterior synechiae.
OBJECTIVE: To evaluate the impact of the extent of peripheral anterior synechiae (PAS) on the effectiveness and safety of combined phacoemulsification (PEI), goniosynechialysis (GSL), and goniotomy (GT) in eyes with primary angle closure glaucoma (PACG) and cataract.
METHODS: This study included patients diagnosed with PACG and cataracts who underwent combined PEI and 120 degrees GSL plus GT (PEI+GSL+GT) between April 2020 and October 2022 at 10 ophthalmic institutes. Eligible patients were divided into 3 groups based on the extent of PAS: 180°≤PAS<270°, 270°≤PAS<360°, and PAS=360°. Data on intraocular pressure (IOP), the number of ocular hypotensive medications, and complications were collected and compared. The study defined complete success as postoperative IOP within the 6-18 mm Hg range and a 20% reduction from baseline without the use of topical medications. Qualified success was defined in the same way as complete success, but it allowed for the use of ocular hypotensive medications.
RESULTS: Three hundred four eyes of 283 patients were included. The mean follow-up was 12.50±1.24 months. All groups experienced a significant reduction in IOP after the surgery ( P <0.05). There were no significant differences in final IOP, number of medications, and cumulative complete and qualified success rates among the 3 groups ( P >0.05). The groups with 270°≤PAS<360°had a higher frequency of hyphema compared with 180°≤PAS<270° ( P = 0.044).
CONCLUSIONS: PEI+GSL+GT has proven to be an effective treatment for PACG with cataracts over a 1 year period. However, the outcome was not correlated with the preoperative extent of PAS.
OBJECTIVE: To evaluate the impact of the extent of peripheral anterior synechiae (PAS) on the effectiveness and safety of combined phacoemulsification (PEI), goniosynechialysis (GSL), and goniotomy (GT) in eyes with primary angle closure glaucoma (PACG) and cataract.
METHODS: This study included patients diagnosed with PACG and cataracts who underwent combined PEI and 120 degrees GSL plus GT (PEI+GSL+GT) between April 2020 and October 2022 at 10 ophthalmic institutes. Eligible patients were divided into 3 groups based on the extent of PAS: 180°≤PAS<270°, 270°≤PAS<360°, and PAS=360°. Data on intraocular pressure (IOP), the number of ocular hypotensive medications, and complications were collected and compared. The study defined complete success as postoperative IOP within the 6-18 mm Hg range and a 20% reduction from baseline without the use of topical medications. Qualified success was defined in the same way as complete success, but it allowed for the use of ocular hypotensive medications.
RESULTS: Three hundred four eyes of 283 patients were included. The mean follow-up was 12.50±1.24 months. All groups experienced a significant reduction in IOP after the surgery ( P <0.05). There were no significant differences in final IOP, number of medications, and cumulative complete and qualified success rates among the 3 groups ( P >0.05). The groups with 270°≤PAS<360°had a higher frequency of hyphema compared with 180°≤PAS<270° ( P = 0.044).
CONCLUSIONS: PEI+GSL+GT has proven to be an effective treatment for PACG with cataracts over a 1 year period. However, the outcome was not correlated with the preoperative extent of PAS.
摘要：
目的：评估外周前粘连（PAS）程度对联合超声乳化（PEI）的有效性和安全性的影响，性腺分离(GSL),原发性闭角型青光眼（PACG）和白内障的眼角切开术（GT）。
方法：这项研究包括在2020年4月至2022年10月期间在10个眼科研究所接受PEI和120度GSL加GT（PEIGSLGT）联合诊断为PACG和白内障的患者。符合条件的患者根据PAS的程度分为三组：180°≤PAS<270°，270°≤PAS<360°,PAS=360°。眼内压（IOP）数据，降眼药物的数量，收集并比较并发症。该研究将完全成功定义为术后IOP在6-18mmHg范围内，并且在不使用局部药物的情况下从基线降低20％。合格的成功与完全成功的定义相同，但它允许使用降眼药物。
结果：包括283例患者的三百四只眼。平均随访12.50±1.24个月。各组术后IOP均显著降低(P<0.05)。最终IOP没有显着差异，药物的数量,3组累计完全和合格成功率(P>0.05)。270°≤PAS<360°组的前房积血发生率高于180°≤PAS<270°组(P=0.044)。
结论：PEI+GSL+GT已被证明是治疗PACG合并白内障一年的有效方法。然而,结果与术前PAS程度无关.
结论：超声乳化联合手术，房角分离和房角切开术是原发性闭角型青光眼合并白内障的有效治疗方法，这与术前外周前粘连的程度无关。
方法：这项研究包括在2020年4月至2022年10月期间在10个眼科研究所接受PEI和120度GSL加GT（PEIGSLGT）联合诊断为PACG和白内障的患者。符合条件的患者根据PAS的程度分为三组：180°≤PAS<270°，270°≤PAS<360°,PAS=360°。眼内压（IOP）数据，降眼药物的数量，收集并比较并发症。该研究将完全成功定义为术后IOP在6-18mmHg范围内，并且在不使用局部药物的情况下从基线降低20％。合格的成功与完全成功的定义相同，但它允许使用降眼药物。
结果：包括283例患者的三百四只眼。平均随访12.50±1.24个月。各组术后IOP均显著降低(P<0.05)。最终IOP没有显着差异，药物的数量,3组累计完全和合格成功率(P>0.05)。270°≤PAS<360°组的前房积血发生率高于180°≤PAS<270°组(P=0.044)。
结论：PEI+GSL+GT已被证明是治疗PACG合并白内障一年的有效方法。然而,结果与术前PAS程度无关.
结论：超声乳化联合手术，房角分离和房角切开术是原发性闭角型青光眼合并白内障的有效治疗方法，这与术前外周前粘连的程度无关。
