Publication: Real-world surgical outcomes of primary angle-closure glaucoma
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Issued Date
2021
Resource Type
Language
eng
File Type
application/pdf
ISSN
11775467
Other identifier(s)
2-s2.0-85109407114
Rights Holder(s)
Scopus
Bibliographic Citation
Clinical Ophthalmology. Vol 15, No. (2021), p.2823-2833
Suggested Citation
Wanichwecharungruang B., Phumratprapin C., Kongsomboon K., Seresirikachorn K. Real-world surgical outcomes of primary angle-closure glaucoma. Clinical Ophthalmology. Vol 15, No. (2021), p.2823-2833. doi:10.2147/OPTH.S315747 Retrieved from: https://hdl.handle.net/20.500.14740/8019
Abstract
Purpose: To evaluate surgical outcomes of the four common procedures utilized for primary angle-closure glaucoma (PACG). Methods: A retrospective study of survival rate in surgical management of PACG was conducted in a referral eye center. One hundred and ninety-nine eyes from 173 PACG patients were collected for chart review. The procedures used were phacoemulsification (PE), combined PE with goniosynechialysis (PE-GSL), combined PE with trabeculectomy (PE-Trab), and trabeculectomy alone. Failure was defined as postoperative IOP >21 mmHg in patients who needed second surgical intervention or those who had IOP <5 mmHg with loss of light perception. Cumulative survival rates, risk of surgical failure, and complications were analyzed. Results: PE, PE-GSL, PE-Trab, and trabeculectomy were performed in 84 eyes (42.2%), 76 eyes (38.2%), 21 eyes (10.6%), and 18 eyes (9%), respectively. Cumulative survival rates at 60 months were 13%, 55%, 42% and 43%, respectively. Cox regression analysis indicated that each mmHg IOP increased, the risk of surgical failure decreased by 13% (adjusted hazard ratio (HR) 0.87; 95%CI: 0.84–0.93, p<0.001). Conclusion: Real-world surgical outcomes of PACG showed that PE alone had a low survival rate of 13% in 60-month follow-up whereas PE-GSL achieved the highest rate of 55%. PE-GSL should be initially considered for management of PACG, since it can restore and sustain the physiologic aqueous pathway and preserve the conjunctiva for future filtering surgery if needed. © 2021 Wanichwecharungruang et al.