Zhonghua Yan Ke Za Zhi. 2026 Mar 11;62(3):202-208. doi: 10.3760/cma.j.cn112142-20250425-00198.
ABSTRACT
Objective: To report the recurrence of peripheral angle synechiae (PAS) in primary angle-closure glaucoma (PACG) after phacoemulsification combined with intraocular lens implantation and goniosynechialysis (PEI-GSL) during an intermediate-and long-term follow-up. Methods: This retrospective case series included patients with acute or chronic PACG who underwent PEI-GSL performed by the same surgeon at the Eye Hospital of Wenzhou Medical University between January 2017 and December 2019, with complete postoperative gonioscopic records. The primary outcome measures were the incidence and extent (in clock hours) of recurrent PAS at the last follow-up. The secondary outcomes included the surgical success rate, intraocular pressure, and the number of intraocular pressure-lowering medications. The intergroup comparisons were performed using the generalized estimating equation. The intragroup comparisons before and after surgery were analyzed using the Wilcoxon signed-rank test. The categorical data were compared using the Chi-square test or Fisher’s exact test. Results: A total of 57 patients (69 eyes) were included, with a mean follow-up of 23.3±9.0 months. Among them, 37 patients (41 eyes) had acute PACG [9 males (24.3%), 28 females (75.7%); mean age, (68.6±8.6) years], and 20 patients (28 eyes) had chronic PACG [8 males (40.0%), 12 females (60.0%); mean age, (65.1±8.8) years]. There were no statistically significant differences in gender or age between the two groups (both P>0.05). At the last follow-up, 46.4% (32/69) of eyes maintained a full-circle anterior chamber angle opening or had only several spot adhesions, 82.6% (57/69) had PAS limited to one quadrant, and 89.9% (62/69) had PAS involving fewer than 6 clock hours. The recurrence rate of PAS was 31.9% (22/69) in all eyes, while it was 26.8% (11/41) in eyes with acute PACG, and 39.3% (11/28) in eyes with chronic PACG, with no statistically significant difference (χ²=1.92, P=0.165). However, the extent of recurrent PAS was greater in chronic PACG patients [4.50 (2.50, 8.50) clock hours] than in acute PACG patients [3.00 (1.50, 4.50) clock hours], and this difference was statistically significant (Wald χ²=5.39, P=0.020). Conclusions: Approximately 30% of eyes with PACG develop recurrent PAS after PEI-GSL, but 90% maintain an angle opening over 180°.
PMID:41820064 | DOI:10.3760/cma.j.cn112142-20250425-00198
