Posters

Goniosynechialysis: effective management of secondary angle closure glaucoma

Poster Details

First Author: I. Masood UNITED KINGDOM

Co Author(s):    A. Vergados   P. Pandey   G. Ramsamy   P. Shah           

Abstract Details

Purpose:

Goniosynechialysis is stripping of the peripheral anterior synechiae (PAS) to achieve good control of intra-ocular pressure (IOP). It is widely used in angle closure glaucoma. However, there is little in the literature about the procedure’s intended benefits in cases of raised IOP due to secondary angle closure glaucoma. Our main purpose is to analyse post-operative outcomes on IOP in cases of secondary angle closure treated with goniosynechialysis. To highlight that clinicians should consider referring patients with secondary angle closure as early as possible to aid prognosis.

Setting:

Birmingham andMidland Eye Center, Birmingham, UK

Methods:

Data in this case series was collected retrospectively, including details of ocular history, any intra and/or post-operative complications. IOP trends following goniosynechialysis were analysed, as well as the number of glaucoma medications patients were subsequently prescribed.

Results:

9 eyes of 9 patients were identified in this study (5 males, 4 females). Mean age was 52.4. Causes of secondary angle closure were attributed to interesting cases, including aqueous misdirection, iris bombe, iridotrabecular adhesions and DSAEK. No intraoperative complications were noted during goniosynechialysis. Follow up was available ranging between 6months-2 years. In 4/9 cases IOP remained stable at follow up on no glaucoma medications. One patient required revision surgery using endoscopic gonisynechialysis, after which IOP was stable on 3 glaucoma medications.

Conclusions:

Our study has shown that cases of secondary angle closure are complex to manage solely with medications. It appears that goniosynechialysis can be performed in the routine manner and good IOP control can be achieved. We recommend that clinicians consider early referral for consideration for surgery when patients develop signs of secondary angle closure glaucoma

Financial Disclosure:

NONE