Case Reports

MicroPulse Cyclophotocoagulation combined with phacoemulsification and Kahook Dual Blade-assisted goniosynechialysis and excisional goniotomy for angle closure glaucoma: a case report

Case Report Details

First Author: A.Al Habash SAUDI ARABIA

Co Author(s):    W. Otaif                    

Abstract Details

Purpose:

To report the effectiveness and safety of Microulse Cyclophotocoagulation combined with phacoemulsification and Kahook dual blade assisted Goniosyncholysis and excisional goniotomy for angle closure glaucoma in reduction of intraocular pressure (IOP), and the need for antiglaucoma medications.

Setting:

Case report

Report of Case:

A 39-year-old hyperopic female with known history of right chronic angle closure glaucoma on maximal antiglaucoma medications. She underwent surgical peripheral iridectomy in another hospital and She was offered a right trabeculectomy, which she refused. She presented to our hospital with blurred vision in the right eye, photophobia, and headache. On Examination, she had an uncorrected visual acuity of 20/50 OD, and 20/25 OS. Slit lamp examination of the right eye revealed conjunctival congestion, corneal edema, shallow anterior chamber, fixed and mid-dilated pupil, posterior synachia, and early cataractous changes. Goldman applanation tonometry revealed an IOP of 51 mmHg OD, and 12 mmHg OS. Gonioscopy revealed closed angle with peripheral anterior synechiae. The cup-to-disc ratios were 0.5 OD and 0.3 OS. She underwent right micropulse cyclophotocoagulation combined with phacoemulsification with a posterior chamber intraocular lens and Kahook dual blade assisted goniosyncholysis and excisional goniotomy.Patient visual acuity 20/20 with correction in one year follow up and Intraocular pressure 12mmhg in the last follow up without antiglaucoma medication. Neither optic nerve nor visual field progression was found

Conclusion/Take Home Message:

Microulse Cyclophotocoagulation Combined with phacoemulsification and Kahook dual blade assisted Goniosyncholysis and excisional goniotomy safely provides reduction in both IOP and the need for antiglaucoma medications in eye with angle closure glaucoma while avoiding the long term complications that can be associated with incisional glaucoma surgeries.

Financial Disclosure:

None