Efficacy and safety of combination surgery for advanced angle-closure glaucoma

Key Takeaways

• A combination of three surgeries is safe and effective for the treatment of advanced angle-closure glaucoma. 
• The combination has great potential as a first-line treatment option for patients with advanced angle-closure glaucoma. 

Angle-closure glaucoma is a type of glaucoma in which the iris, the colored part of the eye that surrounds the pupil, bulges. The bulging iris partially or completely blocks the drainage angle and as a result, fluid can’t circulate through the eye and pressure increases. Several surgeries can be used to treat angle-closure glaucoma, including surgical removal of part of the iris (surgical peripheral iridectomy), physically separating the iris from the drainage angle (goniosynechialysis), and creating an opening in the eye’s drainage system to improve drainage and reduce pressure (goniotomy).

A team of researchers evaluated the efficacy and safety of combining the above surgical approaches in patients with advanced angle-closure glaucoma who did not have cataracts. A total of 61 eyes were included in the study. 

The researchers found that after 12 months follow-up, 36 eyes (59%) achieved complete success (reduction in IOP of at least 20% without the use of eye drop medications or repeat surgery), and 56 eyes (91.8%) achieved qualified success (same criteria as complete success but allowed medication use). Therefore, the authors conclude that the combination of these surgeries is a safe and effective surgical approach and has great potential as a first-line treatment option for patients with advanced angle-closure glaucoma. 

Edited by Miriam Kaplan, PhD

Source: Gao, Xinbo et al, “Efficacy and Safety of Surgical Peripheral Iridectomy, Goniosynechialysis, and Goniotomy for Advanced Primary Angle-closure Glaucoma without Cataract: One-year Results of a Multicenter Study.” Journal of Glaucoma, May 24, 2024; DOI: 10.1097/IJG.0000000000002443