In this study we evaluated the safety and efficacy of combined phacoemulsification and synechiolysis without aid of gonioprism lens and intraoperative intracameral tissue plasminogen activator (tPA) injection for angle-closure glaucoma.

The method used in this study was synechiolysis with Kuglen hook without aid of gonioprism lens and intraoperative intracameral tPA injection following cataract surgery.

A total of 20 patients with a mean age of 71.4 ± 5.4 years were treated. Mean follow-up time was 31.3 ± 24.3 months. Mean preoperative and last visit intraocular pressures (IOPs) were 21.70 ± 9.50 mm Hg and 12.40 ± 2.30 mm Hg, respectively ( p < 0.0001). The mean number of glaucoma medications decreased from 2.40 to 0.30 ( p < 0.0001). IOP was maintained below 16 mm Hg in all cases. No significant intraoperative and postoperative complications, hyphema, or fibrin reaction occurred.

Combined phacoemulsification and peripheral anterior synechiolysis with Kuglen hook without aid of gonioprism lens and intraoperative intracameral tPA injection is an effective and safe surgical procedure.