LONG-TERM RESULTS OF NON-FILTERING SURGERY FOR THE TREATMENT OF PRIMARY ANGLE-CLOSURE GLAUCOMA

Background: We previously reported the effectiveness of goniosynechial ysis and trabeculotomy ab externo for adult-onset glaucoma. In this st udy, we performed non-filtering surgery on patients with primary angle -closure glaucoma and studied the long-term outcome of this treatment. Methods: Included in this study were 35 eyes of 25 patients with prim ary angle-closure glaucoma, each of which had an intraocular pressure greater than 20 mmHg with maximal tolerated antiglaucoma medication, e ven after laser iridotomy or surgical iridectomy. Of these 35 eyes, 22 underwent trabeculotomy and 13 underwent goniosynechialysis. All pati ents were followed up for at least 18 months. Results: In 21 (95%) of 22 eyes after trabeculotomy, and in 12 (92%) of 13 eyes after goniosyn echialysis, intraocular pressures were well controlled at or below 21 mmHg at the final examination. However, in two of the 21 eyes in which trabeculotomy was a success, and in four of the 12 eyes in which goni osynechialysis was successful, the procedure had to be repeated before adequate control of pressure was achieved. Conclusion: Our results sh ow that intraocular pressure in most cases of primary angle-closure gl aucoma can be controlled by restructuring of the physiologic aqueous o utflow route by means of goniosynechialysis or trabeculotomy, and that filtering surgery is not necessary.