• J Natl Med Assoc · Feb 2022

    Case Reports

    Case report: Cataract extraction/lensectomy, excisional goniotomy and transscleral cyclophotocoagulation: Affordable combination MIGS for plateau iris glaucoma.

    • Daniel Laroche, Kara Rickford, and Sohail Sakkari.
    • New York Eye and Ear Infirmary, Icahn School of Medicine of Mount Sinai, 310 E 14(th) St, New York, NY, USA; Advanced Eyecare of New York, 29 W 127(th) St, New York, NY, USA. Electronic address: dlarochemd@aol.com.
    • J Natl Med Assoc. 2022 Feb 1; 114 (1): 38-41.

    AbstractWe report the successful treatment of angle closure glaucoma and plateau iris with combined early cataract surgery/lensectomy, goniotomy, and transscleral cyclophotocoagulation. The underlying mechanism of angle closure and plateau iris was addressed with cataract extraction and goniosynechiolysis. Goniotomy was used to enhance trabecular meshwork outflow and lower intraocular pressure, and the "slow burn" transscleral cyclophotocoagulation was safely performed to reduce the size of the ciliary processes. The unique combinations of these procedures restored the iridocorneal angle anatomy to normalize IOP and prevent vision loss from glaucoma in patients with plateau iris. This is a cost-effective option with longer term efficacy.Copyright © 2021. Published by Elsevier Inc.

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