Principle and advantages of using viscoelastic agent undergo goniosynechialysis during glaucoma and cataract combined surgery

Abstract

AIM: To investigate the advantage of using the medical sodium hyaluronate gel undergo goniosynechialysis, and to compare the difference of the viscoelastic agent and perfusion fluid by clinical control study. METHODS:Totally 103 cases(103 eyes)patients who had angle-closure glaucoma(ACG)with cataract all in Beijing Tongren Hospital affiliated to Capital Medical University, from September 2012 to February 2013. All the patients had primary glaucoma or recurrence ACG with cataract. Their intraocular pressure(IOP)could be controlled in normal value using one or two anti-glaucoma medications. We divided all the patients into two groups by chance. Experimental group had 53 cases(50 eyes), and control group had 50 cases(53 eyes). Two groups all had been performed phacoemulsification combined with goniosynechialysis by the same experiential operator. But experimental group did goniosynechialysis using the medical sodium hyaluronate gel, control group did goniosynechialysis using perfusion fluid. We observed the change of IOP, central anterior chamber depth and anterior chamber structure of two groups in postoperative 1mo. RESULTS: SPSS19.0 statistics software was utilized to analyze the data, This study selected one-side test α=0.05, adopted paired t-test or two-sample t-test. We obtained that experimental group IOP decreased 12.42±0.04mmHg, anterior chamber depth increased 1.276±0.201mm; that control group IOP decreased 6.56±0.08mmHg, anterior chamber depth increased 0.852±0.132mm. And experimental group anterior chamber angle opened more widely than the other group, the comparison had statistical significance(PCONCLUSION:In phacoemulsification combine with goniosynechialysis,use medical sodium hyaluronate gel do goniosynechialysis can more effectively decrease IOP. This because the medical sodium hyaluronate gel has high glutinousness, it can separate angle of anterior chamber and controlling IOP effectively.

Keywords

• cataract
• angle-closure glaucoma
• goniosynechialysis
• phacoemulsification cataract extraction
• viscoelastic agent
• perfusion fluid