Comparative Study on the Effect of Phaco and Viscogoniosynechialysis with Phaco and Viscogoniosynechialysis and Goniotomy in Patients with Primary Angle Closure Glaucoma

Purpose: Comparative study on the effect of phaco and viscogoniosynechialysis with phaco and viscogoniosynechialysis and goniotomy in patients with primary angle closure glaucoma. Methods: 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 firstgroup, 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. Results: 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, P value=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 . Conclusion: During 6 months follow-up Phaco+VGSL+Goniotomy is more effective and safe method in primary angle closure glaucoma than Phaco +VGSL.