Efficacy and safety of inferior 180 degrees goniosynechialysis followed bydiode laser peripheral iridoplasty in the treatment of chronic angle-closure glaucoma

Purpose: To report the efficacy and safety of inferior 180 degrees goniosyn echialysis followed by diode laser peripheral iridoplasty in the treatment of chronic angle-closure glaucoma with total synechial angle closure. Methods: Five patients with chronic angle-closure glaucoma and total synech ial angle closure whose intraocular pressures were higher than 21 mm Hg whi le taking maximally tolerated medications underwent goniosynechialysis foll owed by diode laser peripheral iridoplasty to the inferior half of the angl e. Intraoperative complications, postoperative visual acuity, intraocular p ressures, and complications were evaluated. Results: Five eyes of five patients received the operation and the mean fol low-up was 7.6 months (range, 6-12 months). The mean preoperative intraocul ar pressure was 33.8 +/- 5.8 mm Hg. The mean postoperative intraocular pres sure at most recent followup was 15.8 +/- 2.2 mm Hg. Postoperative complica tions included transient increase in intraocular pressure, hyphema, and cat aract. The success rate (intraocular pressure less than 20 mm Hg with or wi thout medication) was 80.0%. Conclusion: It appears that 180 degrees goniosynechialysis followed by diod e laser peripheral iridoplasty is an effective and safe surgical procedure for treating chronic angle-closure glaucoma with total synechial angle clos ure.