Introduction:

• Primary angle-closure glaucoma was determined as the presence of glaucomatous optic neuropathy caused by high IOP related to a synechial closed-angle on gonioscopy and glaucomatous defects in visual fields and absence of any cause of secondary angle closure.

• Outflow reconstructive surgery is a relatively safe procedure because of the absence of a filtering bleb. Trabeculotomy decreases outflow resistance by cleavage of the trabecular meshwork and the inner layers of Schlemm's canal, which are the regions primarily responsible for the resistance to aqueous outflow.

• Some sections of the anterior chamber angle are permanently closed by peripheral anterior synechiae in eyes with chronic angle-closure glaucoma. IOP after removal of the pupillary block depends on the degree of damage to the trabecular meshwork. We combined phacoemulsification and trabeculotomy to try to obtain the lowest possible IOP after a single surgical procedure.


Patients:

• Retrospective clinical study that included 20 eyes of patients who underwent phacoemulsification surgery and IOL implantation combined with trabeculotomy under deep sclerectomy .

• All these patients were found to have PACG together with significant cataract.

• These eyes were found to have extensive peripheral anterior synechiae of more than 180° on gonioscopy.