Clinical outcomes of LAN microhook-assisted goniotomy combined with phacoemulsification in mid-to-late primary angle-closure glaucoma with cataract.

Abstract

Purpose: To explore the clinical efficacy of goniotomy assisted by the LAN microhook goniotomy knife (LAN microhook), combined with phacoemulsification, in managing mid-to-late-stage primary angle-closure glaucoma (PACG) with cataract in a prospective observational context.

Methods: A total of 33 patients (53 eyes) diagnosed with mid-to-late-stage PACG and cataract were recruited between February 2024 and November 2024. Preoperative and six-month postoperative data were collected, including intraocular pressure (IOP), antiglaucoma medication use, anterior chamber depth (ACD), peripapillary retinal nerve fiber layer (RNFL) thickness, best-corrected visual acuity (BCVA, logMAR), and surgical complications.

Results: At baseline, IOP was 18.26 ± 4.52 mmHg and declined to 14.11 ± 2.87 mmHg at Month 6. The mean number of antiglaucoma medications were 1.91 ± 0.81 preoperatively, and all patients discontinued medications by Month 6. ACD increased from 2.36 ± 0.39 mm preoperatively to 3.68 ± 0.75 mm at Month 6.

Conclusions: Goniotomy using the LAN microhook combined with phacoemulsification appears to effectively deepen the anterior chamber, lower IOP, improve visual acuity, and eliminate the need for antiglaucoma medication in patients with mid-to-late-stage PACG and cataract.