• This retrospective study found that combining phacoemulsification and goniosynechialysis reduces IOP, medication requirements and the need for further surgery in subjects with angle closure.

    The authors reviewed the charts of 42 patients with acute or chronic angle closure who underwent combined phacoemulsification and goniosynechialysis between 2003 and 2011 at three centers.

    At a mean follow-up of 25 months, mean IOP and medication requirements were significantly reduced (P ≤ 0.01), as was the need for further surgery. The procedure was more effective in lowering IOP in patients with acute angle closure compared with chronic angle closure (18.3  ±  22.7  mmHg vs. 5.4  ±  4.1  mmHg; P  =  0.007).

    They write that a similar benefit might be expected from clear lens extraction. Prospective studies would be useful to quantify the additional benefit of goniosynechialysis over lens extraction and better identify those who would benefit the most from this procedure.