Efficacy of goniosynechialysis for advanced chronic angle-closure glaucoma

Guoping Qing,1,2 Ningli Wang,1 Dapeng Mu11Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology and Visual Sciences Key Lab, Beijing, China; 2State Key Laboratory of Brain and Cognitive Science, Institute of Biophysics, Chinese Academy of Sciences, B...

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Autores principales:	Qing G, Wang N, Mu D
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2012
Materias:	Ophthalmology RE1-994
Acceso en línea:	https://doaj.org/article/0f361c21beed46e3bece91c1d76717b1
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spelling	oai:doaj.org-article:0f361c21beed46e3bece91c1d76717b12021-12-02T00:24:16ZEfficacy of goniosynechialysis for advanced chronic angle-closure glaucoma1177-54671177-5483https://doaj.org/article/0f361c21beed46e3bece91c1d76717b12012-10-01T00:00:00Zhttp://www.dovepress.com/efficacy-of-goniosynechialysis-for-advanced-chronic-angle-closure-glau-a11382https://doaj.org/toc/1177-5467https://doaj.org/toc/1177-5483Guoping Qing,1,2 Ningli Wang,1 Dapeng Mu11Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology and Visual Sciences Key Lab, Beijing, China; 2State Key Laboratory of Brain and Cognitive Science, Institute of Biophysics, Chinese Academy of Sciences, Beijing, ChinaPurpose: To evaluate the intraocular pressure (IOP)-lowering efficacy of goniosynechialysis (GSL) for advanced chronic angle-closure glaucoma (CACG) using a simplified slit-lamp technique.Patients and methods: Patients with CACG with one severely affected eye with best-corrected visual acuity below 20/200 and a mildly or functionally unaffected fellow eye were enrolled in this study. All patients underwent ophthalmologic examinations including measurement of visual acuity, best-corrected visual acuity, and IOP; biomicroscopy; specular microscopy; fundus examination; and gonioscopy followed by anterior chamber paracentesis and GSL for nasal peripheral anterior synechiae in the eye with severe CACG.Results: Thirty patients (18 men, 12 women) were identified as having CACG with an initial mean IOP of 47.1 &plusmn; 6.7 mmHg (range 39&ndash;61 mmHg) in the severely affected eye. One week after GSL, the mean IOP of the treated eyes decreased to 19.3 &plusmn; 2.8 mmHg (range 14&ndash;26 mmHg) without antiglaucoma medication (average decrease 27.7 &plusmn; 6.5 mmHg; range 16&ndash;41 mmHg), which was significant (P &lt; 0.00001) compared with baseline. After an average follow-up period of 36.6 &plusmn; 1.0 months (range 35&ndash;38 months), the mean IOP stabilized at 17.4 &plusmn; 2.2 mmHg (range 12&ndash;21 mmHg). The nasal angle recess did not close again in any one of the patients during the follow-up period. The average significant (P &lt; 0.00001) decrease in corneal endothelial cell density in the treated eyes was 260 &plusmn; 183 cells/mm2 (range 191&ndash;328 cells/mm2).Conclusions: Anterior chamber paracentesis and GSL lowers IOP in advanced CACG, though it may lead to mild corneal endothelial cell loss.Keywords: angle-closure glaucoma, surgery, intraocular pressure, treatmentQing GWang NMu DDove Medical PressarticleOphthalmologyRE1-994ENClinical Ophthalmology, Vol 2012, Iss default, Pp 1723-1729 (2012)
institution	DOAJ
collection	DOAJ
language	EN
topic	Ophthalmology RE1-994
spellingShingle	Ophthalmology RE1-994 Qing G Wang N Mu D Efficacy of goniosynechialysis for advanced chronic angle-closure glaucoma
description	Guoping Qing,1,2 Ningli Wang,1 Dapeng Mu11Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology and Visual Sciences Key Lab, Beijing, China; 2State Key Laboratory of Brain and Cognitive Science, Institute of Biophysics, Chinese Academy of Sciences, Beijing, ChinaPurpose: To evaluate the intraocular pressure (IOP)-lowering efficacy of goniosynechialysis (GSL) for advanced chronic angle-closure glaucoma (CACG) using a simplified slit-lamp technique.Patients and methods: Patients with CACG with one severely affected eye with best-corrected visual acuity below 20/200 and a mildly or functionally unaffected fellow eye were enrolled in this study. All patients underwent ophthalmologic examinations including measurement of visual acuity, best-corrected visual acuity, and IOP; biomicroscopy; specular microscopy; fundus examination; and gonioscopy followed by anterior chamber paracentesis and GSL for nasal peripheral anterior synechiae in the eye with severe CACG.Results: Thirty patients (18 men, 12 women) were identified as having CACG with an initial mean IOP of 47.1 &plusmn; 6.7 mmHg (range 39&ndash;61 mmHg) in the severely affected eye. One week after GSL, the mean IOP of the treated eyes decreased to 19.3 &plusmn; 2.8 mmHg (range 14&ndash;26 mmHg) without antiglaucoma medication (average decrease 27.7 &plusmn; 6.5 mmHg; range 16&ndash;41 mmHg), which was significant (P &lt; 0.00001) compared with baseline. After an average follow-up period of 36.6 &plusmn; 1.0 months (range 35&ndash;38 months), the mean IOP stabilized at 17.4 &plusmn; 2.2 mmHg (range 12&ndash;21 mmHg). The nasal angle recess did not close again in any one of the patients during the follow-up period. The average significant (P &lt; 0.00001) decrease in corneal endothelial cell density in the treated eyes was 260 &plusmn; 183 cells/mm2 (range 191&ndash;328 cells/mm2).Conclusions: Anterior chamber paracentesis and GSL lowers IOP in advanced CACG, though it may lead to mild corneal endothelial cell loss.Keywords: angle-closure glaucoma, surgery, intraocular pressure, treatment
format	article
author	Qing G Wang N Mu D
author_facet	Qing G Wang N Mu D
author_sort	Qing G
title	Efficacy of goniosynechialysis for advanced chronic angle-closure glaucoma
title_short	Efficacy of goniosynechialysis for advanced chronic angle-closure glaucoma
title_full	Efficacy of goniosynechialysis for advanced chronic angle-closure glaucoma
title_fullStr	Efficacy of goniosynechialysis for advanced chronic angle-closure glaucoma
title_full_unstemmed	Efficacy of goniosynechialysis for advanced chronic angle-closure glaucoma
title_sort	efficacy of goniosynechialysis for advanced chronic angle-closure glaucoma
publisher	Dove Medical Press
publishDate	2012
url	https://doaj.org/article/0f361c21beed46e3bece91c1d76717b1
work_keys_str_mv	AT qingg efficacyofgoniosynechialysisforadvancedchronicangleclosureglaucoma AT wangn efficacyofgoniosynechialysisforadvancedchronicangleclosureglaucoma AT mud efficacyofgoniosynechialysisforadvancedchronicangleclosureglaucoma
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Efficacy of goniosynechialysis for advanced chronic angle-closure glaucoma

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