Two-Year Outcomes of Phacogoniotomy vs Phacotrabeculectomy for Advanced Primary Angle-Closure Glaucoma With…

Randomized trialJAMA ophthalmology· Jun 2025

Two-Year Outcomes of Phacogoniotomy vs Phacotrabeculectomy for Advanced Primary Angle-Closure Glaucoma With Cataract: A Noninferiority Randomized Clinical Trial.

Yunhe Song, Sujie Fan, Li Tang … PVP Study Group

GlaucomaRandomized trialTreatmentQ1IF 3.5

Phacogoniotomy lowers eye pressure as well as phacotrabeculectomy at 2 years

Two-Year Outcomes of Phacogoniotomy vs Phacotrabeculectomy for Advanced Primary Angle-Closure Glaucoma With Cataract: A Noninferiority Randomized Clinical Trial.

Yunhe Song … PVP Study Group

JAMA ophthalmology · Jun 2025 · Q1 in Ophthalmology

Purpose

To investigate if phacogoniotomy is noninferior to phacotrabeculectomy for advanced primary angle-closure glaucoma with cataract at 2 years.

Methods

DESIGN, SETTING, AND PARTICIPANTS: This multicenter, noninferiority, randomized clinical trial took place in 7 ophthalmology centers in China.

n = 124 participants

Results

phacogoniotomy lowered eye pressure slightly more, a difference too small to matter

MD -0.50 (95% CI -1.70 to 0.80)

null 0

-1.70

0.80

CI crosses the null - not significant

More results

A total of 59 patients (90.7%) in the phacogoniotomy group and 52 patients (88.1%) in the phacotrabeculectomy group completed 2-year visits.

All participants were Chinese.

More results

The mean difference for complete success for phacogoniotomy vs phacotrabeculectomy was -6.7% (95% CI, -21.4% to 8.8%; P = .47) and for qualified success was 1.4% (95% CI, -11.0% to 14.3%, P = .30).

“

Conclusion · 1 of 2

Mean IOP reduction with phacogoniotomy was noninferior to phacotrabeculectomy for advanced primary angle-closure glaucoma and cataract at 2-year follow-up with no differences detected in complete or qualified success or mean number of antiglaucomatous medications.

Conclusion · 2 of 2

These findings support phacogoniotomy as an alternative to phacotrabeculectomy for patients with advanced primary angle-closure glaucoma and cataract.

Two-Year Outcomes of Phacogoniotomy vs Phacotrabeculectomy for Advanced Primary Angle-Closure Glaucoma With Cataract: A Noninferiority Randomized Clinical Trial.

Two-Year Outcomes of Phacogoniotomy vs Phacotrabeculectomy for Advanced Primary Angle-Closure Glaucoma With Cataract: A Noninferiority Randomized Clinical Trial.

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