Goniosynechialysis

Abstract

© 2015, Elsevier Limited. All rights reserved. Goniosynechialysis (GSL) is a surgical procedure designed to strip the synechiae from the angle wall and restore the trabecular outflow. The success of the procedure depends not only on the preoperative duration but also the recurrence of the PAS. Goniosynechialysis becomes more effective when performed after lens removal. An increase in the anterior chamber space provides ample room to perform the procedure and reduces the chance of synechial reformation. Combined phacoemulsification and GSL (phaco-GSL) has been shown to be safe and highly effective in controlling IOP and decreasing PAS. Goniosynechialysis is contraindicated in patients who are likely to have changes to the trabecular meshwork from long-standing PAS. Patients with congenital angle anomalies and secondary angle closure following uveitis or membranous pulling from neovascularization, iridocorneal endothelial syndrome, or posterior polymorphous dystrophy, are poor candidates.