Deep Sclerectomy with Goniosynechiolysis Ab Interno for Chronic Glaucoma Associated with Peripheral Anterior Synechiae

Purpose. To report one-year results of phacoemulsification combined with deep sclerectomy and goniosynechiolysis ab interno for chronic glaucoma associated with peripheral anterior synechiae (PAS). Methods. We retrospectively analyzed medical charts of 16 patients (20 eyes) treated by one-site combi...

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Main Authors: Alireza Mirshahi, Peter Raak, Katharina Ponto, Bernhard Stoffelns, Katrin Lorenz, Gábor B. Scharioth
Format: Article
Language:English
Published: Hindawi Limited 2015-01-01
Series:Journal of Ophthalmology
Online Access:http://dx.doi.org/10.1155/2015/625719
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spelling doaj-e82e30bbad3a43d0bcfdf8e4a2c28f7a2020-11-24T22:52:04ZengHindawi LimitedJournal of Ophthalmology2090-004X2090-00582015-01-01201510.1155/2015/625719625719Deep Sclerectomy with Goniosynechiolysis Ab Interno for Chronic Glaucoma Associated with Peripheral Anterior SynechiaeAlireza Mirshahi0Peter Raak1Katharina Ponto2Bernhard Stoffelns3Katrin Lorenz4Gábor B. Scharioth5Dardenne Eye Hospital, 53177 Bonn, GermanyAurelios Eye Center, 45657 Recklinghausen, GermanyDepartment of Ophthalmology, University Medical Center, Johannes Gutenberg-University, 55131 Mainz, GermanyDepartment of Ophthalmology, University Medical Center, Johannes Gutenberg-University, 55131 Mainz, GermanyDepartment of Ophthalmology, University Medical Center, Johannes Gutenberg-University, 55131 Mainz, GermanyAurelios Eye Center, 45657 Recklinghausen, GermanyPurpose. To report one-year results of phacoemulsification combined with deep sclerectomy and goniosynechiolysis ab interno for chronic glaucoma associated with peripheral anterior synechiae (PAS). Methods. We retrospectively analyzed medical charts of 16 patients (20 eyes) treated by one-site combined phacoemulsification and deep sclerectomy with goniosynechiolysis ab interno. PAS were transected by a spatula introduced into the anterior chamber through a paracentesis. To account for the correlation of right and left eyes a linear mixed model with unstructured covariance structure was calculated. Results. The mean preoperative intraocular pressure (IOP) was 20.3±5.2 mmHg with 2.4±1.0 medications. One year postoperatively, the mean IOP was 15.3±3.3 mmHg (P=0.004, paired t-test) with 0.6±1.0 medications. A postoperative IOP of ≤21 mmHg without medication was achieved in 17 of 19 eyes (89.5%) and in 12/19 eyes (63.2%) at 3 and 12 months after surgery, respectively. In the remaining eyes (10.5% at 3 months and 36.8% at 12 months), additional medication led to an IOP ≤21 mmHg or the target pressure. No case required further glaucoma surgery. In one eye, conversion of the surgery to trabeculectomy was necessary due to Descemet’s window rupture. Conclusions. With goniosynechiolysis ab interno, effective and safe nonpenetrating glaucoma surgery is possible in presence of PAS.http://dx.doi.org/10.1155/2015/625719
collection DOAJ
language English
format Article
sources DOAJ
author Alireza Mirshahi
Peter Raak
Katharina Ponto
Bernhard Stoffelns
Katrin Lorenz
Gábor B. Scharioth
spellingShingle Alireza Mirshahi
Peter Raak
Katharina Ponto
Bernhard Stoffelns
Katrin Lorenz
Gábor B. Scharioth
Deep Sclerectomy with Goniosynechiolysis Ab Interno for Chronic Glaucoma Associated with Peripheral Anterior Synechiae
Journal of Ophthalmology
author_facet Alireza Mirshahi
Peter Raak
Katharina Ponto
Bernhard Stoffelns
Katrin Lorenz
Gábor B. Scharioth
author_sort Alireza Mirshahi
title Deep Sclerectomy with Goniosynechiolysis Ab Interno for Chronic Glaucoma Associated with Peripheral Anterior Synechiae
title_short Deep Sclerectomy with Goniosynechiolysis Ab Interno for Chronic Glaucoma Associated with Peripheral Anterior Synechiae
title_full Deep Sclerectomy with Goniosynechiolysis Ab Interno for Chronic Glaucoma Associated with Peripheral Anterior Synechiae
title_fullStr Deep Sclerectomy with Goniosynechiolysis Ab Interno for Chronic Glaucoma Associated with Peripheral Anterior Synechiae
title_full_unstemmed Deep Sclerectomy with Goniosynechiolysis Ab Interno for Chronic Glaucoma Associated with Peripheral Anterior Synechiae
title_sort deep sclerectomy with goniosynechiolysis ab interno for chronic glaucoma associated with peripheral anterior synechiae
publisher Hindawi Limited
series Journal of Ophthalmology
issn 2090-004X
2090-0058
publishDate 2015-01-01
description Purpose. To report one-year results of phacoemulsification combined with deep sclerectomy and goniosynechiolysis ab interno for chronic glaucoma associated with peripheral anterior synechiae (PAS). Methods. We retrospectively analyzed medical charts of 16 patients (20 eyes) treated by one-site combined phacoemulsification and deep sclerectomy with goniosynechiolysis ab interno. PAS were transected by a spatula introduced into the anterior chamber through a paracentesis. To account for the correlation of right and left eyes a linear mixed model with unstructured covariance structure was calculated. Results. The mean preoperative intraocular pressure (IOP) was 20.3±5.2 mmHg with 2.4±1.0 medications. One year postoperatively, the mean IOP was 15.3±3.3 mmHg (P=0.004, paired t-test) with 0.6±1.0 medications. A postoperative IOP of ≤21 mmHg without medication was achieved in 17 of 19 eyes (89.5%) and in 12/19 eyes (63.2%) at 3 and 12 months after surgery, respectively. In the remaining eyes (10.5% at 3 months and 36.8% at 12 months), additional medication led to an IOP ≤21 mmHg or the target pressure. No case required further glaucoma surgery. In one eye, conversion of the surgery to trabeculectomy was necessary due to Descemet’s window rupture. Conclusions. With goniosynechiolysis ab interno, effective and safe nonpenetrating glaucoma surgery is possible in presence of PAS.
url http://dx.doi.org/10.1155/2015/625719
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