Official ESCRS | European Society of Cataract & Refractive Surgeons


Goniosynechialysis: an effective management strategy for secondary angle-closure glaucoma

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Session Details

Session Title: Presented Poster Session: Glaucoma II

Venue: Poster Village: Pod 3

First Author: : N.Nizamani UK

Co Author(s): :    I. Masood                       

Abstract Details


To analyse post-operative IOP outcomes in cases of refractory secondary angle closure glaucoma unresponsive to medical therapy treated with goniosynechialysis.


Birmingham & Midlands Eye Center, Birmingham.


Data in this case series was collected retrospectively, including details of ocular history, any intra and/or post-operative complications. IOP trends following goniosynechialysis were analysed, as well as the number of glaucoma medications.


Ten patients with secondary ACG were included in this study. The causes of secondary angle closure were attributed to aqueous misdirection, iris bombe, iridocapsular adhesions following complex retinal surgery and following endothelial keratoplasty. No intra-operative complications were noted during goniosynechialysis. The mean pre-operative IOP 34.90 ± 10.268 mm Hg (range: 22 – 50 mm Hg). The mean IOP at one year follow up visit was 13.2 ± 3.259 mm Hg (range: 10 – 18 mm Hg). At one year follow up in 50% of the cases the IOP remained controlled without IOP lowering medication.


Cases of secondary angle closure glaucoma are complex and often require GDD implantation in the sulcus or pars plana. Goniosynechialysis is a minimally invasive intervention which re-establishes outflow and our study has shown that good IOP control can be achieved with this approach. We recommend that clinicians consider early referral for consideration of surgery when patients develop signs of secondary angle closure glaucoma.

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