<i>Treatment of </i>Severe Chronic Angle Closure Glaucoma with <i>"Double Punctures-Goniosynechialysis",</i> a Case Report

Zhao Junhong; Zhou You; Wang Lulu; Gong Yujing; Guo Hongliang

doi:doi:10.11648/j.ijovs.20220702.17

| Peer-Reviewed

Treatment of Severe Chronic Angle Closure Glaucoma with "Double Punctures-Goniosynechialysis", a Case Report

Zhao Junhong, Zhou You, Wang Lulu, Gong Yujing, Guo Hongliang

Published in International Journal of Ophthalmology & Visual Science (Volume 7, Issue 2)

Received: 11 May 2022 Accepted: 1 June 2022 Published: 8 June 2022

Views: Downloads:

Download PDF

Share This Article

Twitter
Linked In
Facebook

Abstract

Objective: By introducing a method of treating severe chronic closed glaucoma, "double puncture goniosynechialysis", observes the changes of anterior chamber with intraoperative OCT. Methods: For patients with severe chronic angle-closure glaucoma with cataract complications, anterior chamber puncture and vitreous puncture are used to extract fluid, and finally the anterior chamber is pressurized to deepen the anterior chamber. Then surgical phacoemulsification combined with goniotomy was performed three weeks later. The patient's postoperative eyes were observed twice for changes in intraocular pressure and chamber angle. RESULTS: After the patient underwent double puncture-angiotomy, the intraocular pressure was reduced from 45mmHg to 16-30mmHg, and the angle of opening was changed from 0 to 90 degrees. After phacoemulsification combined with goniotomy, the intraocular pressure was reduced to normal, and the chamber angle was opened at 210 degrees. CONCLUSION: After opening part of the chamber angle through double puncture goniotomy to lower the intraocular pressure of the patient, phacoemulsification combined with goniotomy to further open the chamber angle and reduce the intraocular pressure is the most effective treatment for patients with severe chronic angle-closure glaucoma. best treatment plan. The point of the scheme is that it uses internal drainage surgery instead of filtering surgery, which can achieve long-term control and reduce the patient's intraocular pressure.

Published in	International Journal of Ophthalmology & Visual Science (Volume 7, Issue 2)
DOI	10.11648/j.ijovs.20220702.17
Page(s)	78-82
Creative Commons	This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.
Copyright	Copyright © The Author(s), 2024. Published by Science Publishing Group

Keywords

Severe Acute Angle-Closure Glaucoma, Anterior Chamber Paracentesis, Vitreous Paracentesis, Surgical Treatment, Double Puncture-Goniotomy

References

[1]	Tham Y-C, Li X, Wong TY, et al. Global prevalence of glaucoma and projections of glaucoma burden through 2040: a systematic review and meta-analysis. Ophthalmology 2014; 121: 2081–2090.
[2]	Foster PJ, Buhrmann R, Quigley HA, Johnson GJ. The definition and classification of glaucoma in prevalence surveys. Br J Ophthalmol 2002; 86: 238–242.
[3]	Liu C, Nongpiur M E, Khor C-C, et al. Primary angle closure glaucoma genomic associations and disease mechanism [J]. Current Opinion in Ophthalmology, 2020; 31 (2): 101-106.
[4]	Jun-hong Zhao, Jian-qiang Guo, Hua Tian, et al, Clinical significance of reopening anterior chamber angle for severe acute angle-closure glaucoma. Guoji Yanke Zazhi, 2018 (07): 1290-1294.
[5]	Hui Zhang, Kai Cao, Hong-yan Jia, et al. Clinical characteristics, rates of blindness, and geographic features of PACD in China. CAN J Ophthalmol, 2021, 56 (1): 1-6.
[6]	Yang J, Qu Y, Li B, et al, Epidemiological Characteristics of Inpatients Undergoing Surgery for Glaucoma at Tianjin Eye Hospital from 2013 to 2017. J Ophthalmol 2021; 2021: 3628481.
[7]	Lam DS, Tham CC, Lai JS, et al. Current approaches to the management of acute primary angle closure. Curr Opin Ophthalmol, 2007, 18 (2): 146-151.
[8]	Glaucoma Section, Eye Science Branch, Chinese Medical Association. Expert consensus on reconstruction of aqueous outflow drainage in China (2017). Chin J Ophthalmol, 2017, 53 (03): 167-169.
[9]	Ning-li Wang. To meet the arrival of the era of minimally invasive glaucoma surgery. Ophthalmology CHN, 2013, 23 (1): 1-3.
[10]	Ning-li Wang, Ou-yang Jie, Wen-bing Zhou, et al. Multiple patterns of angle closure mechanisms in primary angle closure glaucoma in Chinese. Chin J Ophthalmol, 2000, 36 (1): 46-51.
[11]	Ritch R, Lowe RF, Krupin T. The glaucomas, 2nd. Edn. St Louis: Mosby; 1996: 801-802.
[12]	Chandler PA, Simmons RJ, Grant WM. Malignant Glaucoma, Medical and Surgical Treatment. AM J Ophthalmol, 1968, 66 (3): 495-502.
[13]	Jun-hong Zhao, Hai-tao Hu, Pei-lin Lv, et al. Vitreous aspiration in the treatment of acute angle-closure glaucoma hardcontrolled by drug. Guoji Yanke Zazzhi, 2011 (05): 858-860.
[14]	Qian Z, Huang J, Song B, Wei L, Fu L, Austin MW, Spaeth GL, Pan W, McAlinden C. Cataract Surgery (Phacoemulsification with Intraocular Lens Implantation) Combined with Endoscopic Goniosynechialysis for Advanced Primary Angle-Closure Glaucoma. Ophthalmol Glaucoma. 2021, 4 (4): 365-372.
[15]	He Y, Zhang R, Zhang C, Jia J, Liu H, He B, Quan Z, Zhang J. Clinical outcome of phacoemulsification combined with intraocular lens implantation for primary angle closure/glaucoma (PAC/PACG) with cataract. Am J Transl Res. 2021, 13 (12): 13498-13507.

Cite This Article

Plain Text BibTeX RIS

APA Style

Zhao Junhong, Zhou You, Wang Lulu, Gong Yujing, Guo Hongliang. (2022). Treatment of Severe Chronic Angle Closure Glaucoma with "Double Punctures-Goniosynechialysis", a Case Report. International Journal of Ophthalmology & Visual Science, 7(2), 78-82. https://doi.org/10.11648/j.ijovs.20220702.17

Copy | Download

ACS Style

Zhao Junhong; Zhou You; Wang Lulu; Gong Yujing; Guo Hongliang. Treatment of Severe Chronic Angle Closure Glaucoma with "Double Punctures-Goniosynechialysis", a Case Report. Int. J. Ophthalmol. Vis. Sci. 2022, 7(2), 78-82. doi: 10.11648/j.ijovs.20220702.17

Copy | Download

AMA Style

Zhao Junhong, Zhou You, Wang Lulu, Gong Yujing, Guo Hongliang. Treatment of Severe Chronic Angle Closure Glaucoma with "Double Punctures-Goniosynechialysis", a Case Report. Int J Ophthalmol Vis Sci. 2022;7(2):78-82. doi: 10.11648/j.ijovs.20220702.17

Copy | Download

@article{10.11648/j.ijovs.20220702.17,
  author = {Zhao Junhong and Zhou You and Wang Lulu and Gong Yujing and Guo Hongliang},
  title = {Treatment of Severe Chronic Angle Closure Glaucoma with "Double Punctures-Goniosynechialysis", a Case Report},
  journal = {International Journal of Ophthalmology & Visual Science},
  volume = {7},
  number = {2},
  pages = {78-82},
  doi = {10.11648/j.ijovs.20220702.17},
  url = {https://doi.org/10.11648/j.ijovs.20220702.17},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijovs.20220702.17},
  abstract = {Objective: By introducing a method of treating severe chronic closed glaucoma, "double puncture goniosynechialysis", observes the changes of anterior chamber with intraoperative OCT. Methods: For patients with severe chronic angle-closure glaucoma with cataract complications, anterior chamber puncture and vitreous puncture are used to extract fluid, and finally the anterior chamber is pressurized to deepen the anterior chamber. Then surgical phacoemulsification combined with goniotomy was performed three weeks later. The patient's postoperative eyes were observed twice for changes in intraocular pressure and chamber angle. RESULTS: After the patient underwent double puncture-angiotomy, the intraocular pressure was reduced from 45mmHg to 16-30mmHg, and the angle of opening was changed from 0 to 90 degrees. After phacoemulsification combined with goniotomy, the intraocular pressure was reduced to normal, and the chamber angle was opened at 210 degrees. CONCLUSION: After opening part of the chamber angle through double puncture goniotomy to lower the intraocular pressure of the patient, phacoemulsification combined with goniotomy to further open the chamber angle and reduce the intraocular pressure is the most effective treatment for patients with severe chronic angle-closure glaucoma. best treatment plan. The point of the scheme is that it uses internal drainage surgery instead of filtering surgery, which can achieve long-term control and reduce the patient's intraocular pressure.},
 year = {2022}
}

Copy | Download

TY  - JOUR
T1  - Treatment of Severe Chronic Angle Closure Glaucoma with "Double Punctures-Goniosynechialysis", a Case Report
AU  - Zhao Junhong
AU  - Zhou You
AU  - Wang Lulu
AU  - Gong Yujing
AU  - Guo Hongliang
Y1  - 2022/06/08
PY  - 2022
N1  - https://doi.org/10.11648/j.ijovs.20220702.17
DO  - 10.11648/j.ijovs.20220702.17
T2  - International Journal of Ophthalmology & Visual Science
JF  - International Journal of Ophthalmology & Visual Science
JO  - International Journal of Ophthalmology & Visual Science
SP  - 78
EP  - 82
PB  - Science Publishing Group
SN  - 2637-3858
UR  - https://doi.org/10.11648/j.ijovs.20220702.17
AB  - Objective: By introducing a method of treating severe chronic closed glaucoma, "double puncture goniosynechialysis", observes the changes of anterior chamber with intraoperative OCT. Methods: For patients with severe chronic angle-closure glaucoma with cataract complications, anterior chamber puncture and vitreous puncture are used to extract fluid, and finally the anterior chamber is pressurized to deepen the anterior chamber. Then surgical phacoemulsification combined with goniotomy was performed three weeks later. The patient's postoperative eyes were observed twice for changes in intraocular pressure and chamber angle. RESULTS: After the patient underwent double puncture-angiotomy, the intraocular pressure was reduced from 45mmHg to 16-30mmHg, and the angle of opening was changed from 0 to 90 degrees. After phacoemulsification combined with goniotomy, the intraocular pressure was reduced to normal, and the chamber angle was opened at 210 degrees. CONCLUSION: After opening part of the chamber angle through double puncture goniotomy to lower the intraocular pressure of the patient, phacoemulsification combined with goniotomy to further open the chamber angle and reduce the intraocular pressure is the most effective treatment for patients with severe chronic angle-closure glaucoma. best treatment plan. The point of the scheme is that it uses internal drainage surgery instead of filtering surgery, which can achieve long-term control and reduce the patient's intraocular pressure.
VL  - 7
IS  - 2
ER  -

Copy | Download

Author Information

Zhao Junhong

Department of Ophthalmology, the First Affiliated Hospital of Northwestern University, Xi’an, China
Zhou You

The College of Life Science, Northwestern University (China), Xi’an, China
Wang Lulu

Department of Ophthalmology, the First Affiliated Hospital of Northwestern University, Xi’an, China
Gong Yujing

Department of Ophthalmology, the First Affiliated Hospital of Northwestern University, Xi’an, China
Guo Hongliang

Department of Ophthalmology, the First Affiliated Hospital of Northwestern University, Xi’an, China

Download PDF

Sections

Plain Text BibTeX RIS

APA Style

Zhao Junhong, Zhou You, Wang Lulu, Gong Yujing, Guo Hongliang. (2022). Treatment of Severe Chronic Angle Closure Glaucoma with "Double Punctures-Goniosynechialysis", a Case Report. International Journal of Ophthalmology & Visual Science, 7(2), 78-82. https://doi.org/10.11648/j.ijovs.20220702.17

Copy | Download

ACS Style

Zhao Junhong; Zhou You; Wang Lulu; Gong Yujing; Guo Hongliang. Treatment of Severe Chronic Angle Closure Glaucoma with "Double Punctures-Goniosynechialysis", a Case Report. Int. J. Ophthalmol. Vis. Sci. 2022, 7(2), 78-82. doi: 10.11648/j.ijovs.20220702.17

Copy | Download

AMA Style

Zhao Junhong, Zhou You, Wang Lulu, Gong Yujing, Guo Hongliang. Treatment of Severe Chronic Angle Closure Glaucoma with "Double Punctures-Goniosynechialysis", a Case Report. Int J Ophthalmol Vis Sci. 2022;7(2):78-82. doi: 10.11648/j.ijovs.20220702.17

Copy | Download

@article{10.11648/j.ijovs.20220702.17,
  author = {Zhao Junhong and Zhou You and Wang Lulu and Gong Yujing and Guo Hongliang},
  title = {Treatment of Severe Chronic Angle Closure Glaucoma with "Double Punctures-Goniosynechialysis", a Case Report},
  journal = {International Journal of Ophthalmology & Visual Science},
  volume = {7},
  number = {2},
  pages = {78-82},
  doi = {10.11648/j.ijovs.20220702.17},
  url = {https://doi.org/10.11648/j.ijovs.20220702.17},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijovs.20220702.17},
  abstract = {Objective: By introducing a method of treating severe chronic closed glaucoma, "double puncture goniosynechialysis", observes the changes of anterior chamber with intraoperative OCT. Methods: For patients with severe chronic angle-closure glaucoma with cataract complications, anterior chamber puncture and vitreous puncture are used to extract fluid, and finally the anterior chamber is pressurized to deepen the anterior chamber. Then surgical phacoemulsification combined with goniotomy was performed three weeks later. The patient's postoperative eyes were observed twice for changes in intraocular pressure and chamber angle. RESULTS: After the patient underwent double puncture-angiotomy, the intraocular pressure was reduced from 45mmHg to 16-30mmHg, and the angle of opening was changed from 0 to 90 degrees. After phacoemulsification combined with goniotomy, the intraocular pressure was reduced to normal, and the chamber angle was opened at 210 degrees. CONCLUSION: After opening part of the chamber angle through double puncture goniotomy to lower the intraocular pressure of the patient, phacoemulsification combined with goniotomy to further open the chamber angle and reduce the intraocular pressure is the most effective treatment for patients with severe chronic angle-closure glaucoma. best treatment plan. The point of the scheme is that it uses internal drainage surgery instead of filtering surgery, which can achieve long-term control and reduce the patient's intraocular pressure.},
 year = {2022}
}

Copy | Download

TY  - JOUR
T1  - Treatment of Severe Chronic Angle Closure Glaucoma with "Double Punctures-Goniosynechialysis", a Case Report
AU  - Zhao Junhong
AU  - Zhou You
AU  - Wang Lulu
AU  - Gong Yujing
AU  - Guo Hongliang
Y1  - 2022/06/08
PY  - 2022
N1  - https://doi.org/10.11648/j.ijovs.20220702.17
DO  - 10.11648/j.ijovs.20220702.17
T2  - International Journal of Ophthalmology & Visual Science
JF  - International Journal of Ophthalmology & Visual Science
JO  - International Journal of Ophthalmology & Visual Science
SP  - 78
EP  - 82
PB  - Science Publishing Group
SN  - 2637-3858
UR  - https://doi.org/10.11648/j.ijovs.20220702.17
AB  - Objective: By introducing a method of treating severe chronic closed glaucoma, "double puncture goniosynechialysis", observes the changes of anterior chamber with intraoperative OCT. Methods: For patients with severe chronic angle-closure glaucoma with cataract complications, anterior chamber puncture and vitreous puncture are used to extract fluid, and finally the anterior chamber is pressurized to deepen the anterior chamber. Then surgical phacoemulsification combined with goniotomy was performed three weeks later. The patient's postoperative eyes were observed twice for changes in intraocular pressure and chamber angle. RESULTS: After the patient underwent double puncture-angiotomy, the intraocular pressure was reduced from 45mmHg to 16-30mmHg, and the angle of opening was changed from 0 to 90 degrees. After phacoemulsification combined with goniotomy, the intraocular pressure was reduced to normal, and the chamber angle was opened at 210 degrees. CONCLUSION: After opening part of the chamber angle through double puncture goniotomy to lower the intraocular pressure of the patient, phacoemulsification combined with goniotomy to further open the chamber angle and reduce the intraocular pressure is the most effective treatment for patients with severe chronic angle-closure glaucoma. best treatment plan. The point of the scheme is that it uses internal drainage surgery instead of filtering surgery, which can achieve long-term control and reduce the patient's intraocular pressure.
VL  - 7
IS  - 2
ER  -

Copy | Download