Competing/conflicts of interest: No stated conflict of interest.
Effect of adjunctive viscogonioplasty on drainage angle status in cataract surgery: a randomized clinical trial
Article first published online: 29 OCT 2012
© 2012 The Authors. Clinical and Experimental Ophthalmology © 2012 Royal Australian and New Zealand College of Ophthalmologists
Clinical & Experimental Ophthalmology
Volume 41, Issue 4, pages 368–378, May/June 2013
How to Cite
Eslami, Y., Latifi, G., Moghimi, S., Ghaffari, R., Fakhraie, G., Zarei, R., Jabbarvand, M., Mohammadi, M. and Lin, S. (2013), Effect of adjunctive viscogonioplasty on drainage angle status in cataract surgery: a randomized clinical trial. Clinical & Experimental Ophthalmology, 41: 368–378. doi: 10.1111/j.1442-9071.2012.02871.x
Funding sources: No stated funding sources.
- Issue published online: 5 JUN 2013
- Article first published online: 29 OCT 2012
- Accepted manuscript online: 7 SEP 2012 06:48AM EST
- Manuscript Accepted: 12 AUG 2012
- Manuscript Received: 24 MAY 2012
- anterior chamber depth;
- anterior segment optical coherence tomography;
- primary angle closure glaucoma;
To compare the anatomic effects of phacoemulsification (Phaco) versus combined phacoemulsification and viscogonioplasty (Phaco-VGP) on drainage angle status in primary angle-closure glaucoma (PACG) using anterior segment optical coherence tomography (AS-OCT).
Prospective, randomized clinical trial.
Sixty-seven eyes of 57 patients with the diagnosis of PACG.
Patients were randomized to undergo Phaco alone (33 eyes) or Phaco-VGP (34 eyes). Patients were examined postoperatively on day 1, week 1 and week 6. Indentation gonioscopy and AS-OCT were performed preoperatively and at 6 weeks after surgery.
Main Outcome Measures
Angle and anterior segment parameters by AS-OCT and amount of peripheral anterior synechiae (PAS) by gonioscopy.
Sixty-five eyes of 55 patients completed the trial. The mean extent of PAS was significantly reduced from 127.7 to 95.0 degrees (P < 0.001) by Phaco alone, and from 174.0 to 77.3 degrees (P < 0.001) by Phaco-VGP. Phaco-VGP resulted in significantly greater reduction in PAS extent (P = 0.002). Angle-opening distance and trabecular-iris space-area measured by AS-OCT increased significantly after Phaco alone and Phaco-VGP (P < 0.001 for both). Although the change was higher in the Phaco-VGP group, this did not reach statistical significance. Anterior chamber depth (ACD) increased, and lens vault (LV) decreased after both procedures. The amount of change in ACD and LV was not significant between the two groups.
Both Phaco alone and Phaco-VGP resulted in widening of the drainage angle, deepening of the anterior chamber and reduction of intraocular pressure (IOP) and PAS extent in PACG eyes. Phaco-VGP resulted in significantly more reduction of PAS. However, it seems that additional VGP has no significant effect on short-term IOP.