Center for Ophthalmic Specialized Care (COS), Clinic Montchoisi, Ave Beaumont 9, 1012, Lausanne, Switzerland.
Glaucoma Research Center, Montchoisi Clinic, Swiss Visio, Lausanne, Switzerland.
Int Ophthalmol. 2021 May;41(5):1563-1571. doi: 10.1007/s10792-020-01459-5. Epub 2020 Jun 26.
Pseudoexfoliation syndrome is common in elderly patients and is associated with intraocular pressure elevation. Goniowash is a novel surgical technique to remove pseudoexfoliation material from the irido-corneal angle to decrease intraocular pressure. We assessed the long-term efficacy of Goniowash on relevant parameters in patients with pseudoexfoliation syndrome, after cataract surgery.
The study enrolled 122 patients with pseudoexfoliation syndrome, who underwent routine cataract surgery combined with Goniowash. Best-corrected visual acuity, intraocular pressure and medication status were recorded in study participants during 5 years of follow-up.
Data from 190 eyes (122 patients of average age 73.8 ± 7.7 years) were assessed. Mean best-corrected visual acuity increased from 0.60 to 1.0 (p < 0.001) one year after surgery and remained stable throughout the follow-up. Average intraocular pressure decreased from 26.4 ± 7.3 mmHg pre-operatively to 15.9 ± 3.0 mmHg post operatively at one year (p < 0.001), 16.1 ± 3.3 mmHg (p < 0.001) at 3 years and 16.8 ± 2.9 (p < 0.001) at 5 years. Mean number of ocular hypotensive medications decreased from 1.5 ± 0.8 pre-operatively to 0.4 ± 0.7 post-operatively (75% reduction) (p < 0.001). No unexpected and severe adverse events related to the surgical procedure were reported.
Goniowash combined with cataract surgery provides stable and long-lasting reduction of intraocular pressure and hypotensive medications. It is a safe procedure and may be an alternative for patients with pseudoexfoliation syndrome and elevated intraocular pressure.
假性剥脱综合征常见于老年患者，与眼内压升高有关。Goniowash 是一种从眼前房角清除假性剥脱物质以降低眼内压的新型手术技术。我们评估了 Goniowash 在接受白内障手术后患有假性剥脱综合征的患者相关参数的长期疗效。
该研究纳入了 122 例假性剥脱综合征患者，这些患者接受了常规白内障手术联合 Goniowash。在 5 年的随访期间，研究参与者记录了最佳矫正视力、眼内压和药物治疗情况。
共评估了 190 只眼（122 例患者，平均年龄为 73.8±7.7 岁）的数据。术后 1 年，最佳矫正视力从 0.60 增加到 1.0（p<0.001），整个随访期间保持稳定。平均眼内压从术前的 26.4±7.3mmHg 降至术后 1 年的 15.9±3.0mmHg（p<0.001），术后 3 年的 16.1±3.3mmHg（p<0.001）和术后 5 年的 16.8±2.9mmHg（p<0.001）。术前需要使用 1.5±0.8 种降眼压药物，术后减少至 0.4±0.7（减少 75%）（p<0.001）。未报告与手术相关的意外和严重不良事件。
Goniowash 联合白内障手术可稳定且持久地降低眼内压和降眼压药物的使用。该手术安全，可能是患有假性剥脱综合征和眼内压升高的患者的一种替代治疗方法。
