Objective:

To assess the efficacy and safety of combined phacogoniosynechialysis (Phaco-GSL) with viscocanalostomy and Ologen implant for managing medically uncontrolled primary angle-closure glaucoma (PACG) with peripheral anterior synechia (PAS) ≥ 270°, focusing on primary outcome measures such as IOP reduction and visual acuity.

Key Findings:

• The combined surgical approach effectively reduced IOP in patients with medically uncontrolled PACG, with a mean reduction of X mmHg.
• Goniosynechialysis successfully released PAS, improving aqueous outflow, with Y% of patients achieving target IOP.
• Viscocanalostomy with Ologen implant contributed to sustained IOP control, with Z% of patients maintaining IOP below target at follow-up.

Interpretation:

The study suggests that the combined surgical technique is a viable option for patients with severe PAS and uncontrolled IOP, potentially reducing the need for more invasive procedures.

Limitations:

• Retrospective design limits the ability to establish causation and may introduce selection bias.
• Small sample size may affect the generalizability of the results.
• Lack of long-term follow-up data to assess sustained efficacy.

Conclusion:

Combined phacogoniosynechialysis with viscocanalostomy and Ologen implant is a promising treatment for PACG with extensive PAS, warranting further studies with larger sample sizes for validation.