Clinical Scorecard: Evaluation of Phacogoniosynechialysis Combined with Viscocanalostomy and Ologen Implant in Treating Primary Angle-Closure Glaucoma: A Pilot Retrospective Cohort Analysis

At a Glance

Key Highlights

• Surgical intervention is necessary when IOP is uncontrolled by medications.
• Phacogoniosynechialysis combined with viscocanalostomy and Ologen implant shows promise for PACG management.
• Target IOP set at 15 mmHg for moderate glaucoma and 18 mmHg for mild glaucoma, aiming to prevent further optic nerve damage.

Guideline-Based Recommendations

Diagnosis

• Diagnosis based on IOP > 21 mmHg and glaucomatous field loss.

Management

• Initial management includes laser peripheral iridotomy; surgery considered if medications fail, especially in extensive PAS cases.

Monitoring & Follow-up

• Regular monitoring of IOP and visual field changes.

Risks

• Surgical risks include hypotony, shallow anterior chamber, and endophthalmitis.

Patient & Prescribing Data

Patients with mild to moderate PACG and extensive PAS.

Topical antiglaucoma medications often ineffective in extensive PAS cases, necessitating surgical intervention.

Clinical Best Practices

• Perform goniosynechialysis to release PAS before significant damage occurs.
• Use high-viscosity sodium hyaluronate to manage shallow anterior chamber during surgery.
• Consider patient-specific factors when determining surgical approach.

Related Resources & Content

• European Glaucoma Society Guidelines
• Hodapp et al. grading system