[Phacoemulsification combined with goniosynechialysis under a gonioscope in the treatment of angle-closure glaucoma: the effect of reopening the synechial anterior chamber angle].

A total of 170 consecutive patients (181 eyes) who were diagnosed with primary angle-closure glaucoma (PACG) and underwent phacoemulsification and intraocular lens implantation (PEI) combined with goniosynechialysis (GSL) with an instrument under a gonioscope in the Eye Hospital, Wenzhou Medical University from January 1, 2017 to December 31, 2019 were observed. Anterior chamber angle synechiae of 0 (0, 2) clock hour were released after PEI, while after combined goniosynechialysis, synechiae of 6 (3, 8) clock hours were further released. No matter in chronic PACG and acute PACG with cornea edema, the extent of anterior chamber angle synechiae was different before surgery and after PEI, and so was it in post-PEI and PEI-GSL prospectively (all P<0.01). Phacoemulsification alone can reopen the synechial anterior chamber angle in both chronic PACG and acute PACG in part, but not sufficiently. Combined goniosynechialysis under a gonioscope with an instrument is essential and effective.收集2017年1月1日至2019年12月31日在温州医科大学附属眼视光医院行超声乳化白内障吸除人工晶状体植入（PEI）联合房角镜指导下器械辅助房角分离术（GSL）的170例（181只眼）原发性闭角型青光眼（PACG）合并白内障患者资料进行回顾性分析。术中单纯PEI后开放房角0（0，2）个钟点数，在此基础上进一步器械辅助的房角分离开放房角6（3，8）个钟点数。急性PACG、慢性PACG及术前因角膜水肿无法查房角的患者术前与PEI后、PEI-GSL后与PEI后相比，房角粘连关闭点位差异均有统计学意义（均P<0.01）。无论急性PACG还是慢性PACG，单纯PEI开放房角的范围有限，进一步在房角镜指导下联合器械辅助的GSL可以更大范围地开放房角。.