Comparative study on the effect of “phaco and viscogoniosynechialysis” with “phaco and viscogoniosynechialysis and goniotomy” in patients with primary angle closure glaucoma.

In this randomized clinical trial , 63 eyes of 61 patients with primary angle closure glaucoma were enrolled . Inclusion criteria include patients with angle closure glaucoma as candidate for surgery with a maximum CDR of 80%,absence PAS in nasal quadrant. Then, the patients were randomly assigned to two groups. In first group, the patients underwent “Phaco + VGSL + Goniotomy” and in the second group “Phaco + VGSL”. During the 6-month follow-up, the IOP,antiglaucoma medication,BCVA evaluated (1 week and 1,3,6 moths after surgery). AS-OCT parameters (Casia 1 Tomey) and goniotomy evaluated pre-op and 6 months post-op.

IOP lowering effect in the group “Phaco + VGSL + Goniotomy” more than the group “Phaco + VGSL”. Also, the difference in IOP between the two groups was significant at 3 months (p value=0.014) and 6 months (p value=0.021) after surgery. The analysis between number of antiglaucoma medications and BCVA was not a significant difference(p value=0.671,pvalue=0.092) There was no difference in AS-OCT findings before intervention, but after intervention, the AS-OCT indices [ except for the variables ARA500 (Temporal ), TISA 500 (Temporal), ACW And ACD] was a significant difference between the two groups. As the results show, the difference in “Phaco + VGSL + goniotomy” indices is more than the changes in the group “Phaco + VGSL”.

During 6 months follow-up Phaco+VGSL+Goniotomy is more effective and safe method in primary angle closure glaucoma than Phaco +VGSL.