Speaker: Cataract surgery, goniosynechialysis together increase IOP control in angle closure glaucoma
WASHINGTON — Cataract removal and goniosynechialysis work together to lower IOP in patients with angle closure glaucoma and significant synechiae, possibly avoiding further surgery, a speaker said here.
Even though phacoemulsification alone may result in significant widening of the anterior chamber angle, combining goniosynechialysis with the cataract surgery could achieve better IOP control while also avoiding a trabeculectomy, Marlene R. Moster, MD, told colleagues at the American Glaucoma Society meeting.
Marlene R. Moster
In these cases, Moster said she works through very small 1-mm incisions, using a gonioprism, MST micro-grabbers and viscoelastic, to pull the iris away from the angle.
It is critically important to remove all viscoelastic so as not to have a pressure spike the next day, she said.
To finish the case, Moster applies Miostat (carbachol, Alcon) and hydrates the wound.
“Phacoemulsification and goniosynechialysis for the management of chronic angle closure glaucoma makes perfect sense,” Moster said. “Often times it will restore the anatomy to make this surgery a win-win outcome, with good vision, lower pressure and a more normal-appearing angle structure.”
Disclosure: Moster has no relevant financial disclosures.