The efficacy and safety of combined phacoemulsification, intraocular lens implantation, and limited goniosynechialysis, followed by diode laser peripheral iridoplasty, in the treatment of cataract and chronic angle-closure glaucoma

Purpose: To report the efficacy and safety of combined phacoemulsification, intraocular lens implantation, and limited goniosynechialysis, followed by diode laser peripheral iridoplasty. in the treatment of cataract and chron ic angle-closure glaucoma. Methods: Patients with chronic angle-closure glaucoma with total synechial angle closure and intraocular pressures higher than 21 mm Hg on maximally t olerated medications, and concurrent cataract, underwent phacoemulsificatio n with posterior chamber intraocular lens implantation and goniosynechialys is followed by diode laser peripheral iridoplasty to the inferior half of t he angle. Intraoperative complications, postoperative visual acuity, intrao cular pressures. and complications were evaluated. Results: Seven eyes of seven patients received the operation. and the mean followup was 8.9 months (range, 2-16 months). The mean preoperative intraoc ular pressure was 33.0 +/- 4.8 mm Hg. The mean postoperative intraocular pr essure at most recent follow-up was 13.3 +/- 2.9 mm Hg. The absolute succes s rate (intraocular pressure less than 21 min Hg without medication) was 10 0%. The visual acuity of all eyes improved by more than two Snellen lines. Postoperative complications included intraocular pressure spike. hyphema, a nd transient corneal decompensation. Conclusion: It appears that phacoemulsification with intraocular lens impla ntation combined with inferior 180 degrees goniosynechialysis followed by d iode laser peripheral iridoplasty is an effective and safe surgical procedu re for treating chronic angle-closure glaucoma with total synechial angle c losure and cataract.