The aim of this study is to investigate the clinical efficacy of a novel goniosynechialysis (GSL) with cataract phacoemulsification for primary angle-closure glaucoma (PACG).

Forty-five patients (60 eyes) diagnosed as PACG complicated with cataract in Department of Glaucomatology of Weifang Eye Hospital from October 2021 to September 2022 were selected. Among them, there were 23 cases (28 eyes) male and 22 cases (32 eyes) female with the mean age of (67.5±14.7) years (ranged from 53 to 81 years). They were divided into experimental group 25 cases (30 eyes) and control group 20 cases (30 eyes) according to the random number table method. They all underwent cataract phacoemulsification, then a novel GSL and a conventional method was used for patients of experimental group and control group, respectively. The range of peripheral anterior synechia (PAS) were recorded before, during and postoperation. The volume of viscoelastic used, GSL time and complications were recorded during operation in the two groups. The number of antiglaucoma medications were recorded, intraocular pressure, the count of aqueous flare, best corrected visual acuity, anterior chamber depth and corneal endothelial cell density were measured before operation and after operation for 1 week, 1 month, 3 months, 6 months.The PAS was counted as the number and percentage of eyes, and used to compare by the rank sum test. The volume of viscoelastic used, GSL time, anterior chamber depth, intraocular pressure, best corrected visual acuity, the count of aqueous flare, corneal endothelial cell density were in accordance with normal distribution, and expressed as ±s, and used to compare by the independent samples t test between groups, and used to compare by repeated measures variance analysis at multiple time points. The number of postoperative medications was expressed as M (Q1, Q3), and used to compare by the Mann-Whitney U test between groups.

The GSL time and the volume of viscoelastic used in the experimental group were (1.07±0.77) min and (48.86±11.44) μL, respectively, while those in the control group were (1.07±0.77) min and (119.07±14.08) μL, respectively with the significant difference (t=-10.00, -21.20; P<0.05). The intraocular pressure of the experimental group were (25.30±10.63)mmHg (1 mmHg=0.133 kPa), (17.23±3.20)mmHg, (16.80±2.38)mmHg, (16.97±1.87)mmHg, (17.83±2.56)mmHg after operation for 1 week, 1 month, 3 months, 6 months, respectively; anterior chamber depth were (2.31±0.25)mm, (4.38±0.17)mm, (4.36±0.15)mm, (4.33±0.12)mm and (4.26±0.12)mm, respectively; the count of aqueous flare were (13.67±7.26)pc/ms, (28.01±15.72)pc/ms, (15.81±8.30)pc/ms, (12.12±5.32)pc/ms, (10.63±4.47)pc/ms, respectively; the best corrected visual acuity were (0.37±0.43), (0.15±0.27), (0.14±0.32), (0.16±0.33) and (0.15±0.28), respectively; the corneal endothelial cell density were (2624.07±277.29)mm^2, (2375.70±321.45) mm^2, (2310.13±277.00)mm^2, (2311.80±243.03)mm^2, (2311.10±333.54)mm^2, respectively. There was significant difference in anterior chamber depth, intraocular pressure, the best corrected visual acuity, the count of aqueous flare, and the corneal endothelial cell density at each time point after surgery (F=1.62, 1.53, 1.41, 0.80, 0.25; P>0.05). In the experimental group, there were 16 cases (18 eyes), 5 (8 eyes), 4 cases (4 eyes) in the range of PAS with 0°, 0°to 90°, ≥90° after operation for 1 month, accounting for 60.0%, 26.7%, 13.3%, respectively; were 11 cases (13 eyes), 8 cases (11 eyes), 6 cases (6 eyes) after operation for 6 months, accounting for 43.3%, 43.3%, 20.0%, respectively. There was no statistical difference in the PAS between two groups (Z= -1.65, -0.90; P>0.05). There was no statistical difference in the number of antiglaucoma medications of patients with experimental group and control group after operation for 1 month, 3 months, 6 months (Z=-1.04, -1.25, -0.95; P>0.05); there was no statistical difference in the complication rate between them (χ²=2.04, P>0.05).

A novel GSL is equal to trational method in the clinical efficacy. The novel GSL has the advantages of time saving, less consumables, easy performing and more efficient, which deserve to be widely applied.