Combined Phacoemulsification and Diode Laser Therapy in Chronic Angle Closure Glaucoma

Study Overview
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Brief Summary
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comparing different types of cuclophotocoagulation with cataract extraction to cataract extraction and goniocynechiolysis in cases of chronic angle closure glaucoma

Detailed Description
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Evaluation of the safety of MP-TSCPC , CW-TSCPC and endoscopic cyclophotocoagulation when combined with phacoemulsification in cases with CACG Comparing the efficacy of the combined procedures in control of the IOP and the success rate versus lens extraction combined with synechiolysis

Official Title
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Combined Phacoemulsification and Different Modes of Diode Laser Therapy in Management of Chronic Angle Closure Glaucoma. A Comparative Study

Conditions
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Angle Closure Glaucoma

Intervention / Treatment
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* Procedure: phaco+MP-TSCPC
* Procedure: phaco+TSCPC
* Procedure: phaco+endocyclophotocoagulation
* Procedure: phaco GSL


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Patients between 20 to 70 years chronic angle closure glaucoma Exclusion Criteria: Patients in acute attack of angle closure. Patients with previous filtering surgery or cycloablative procedure

Ages Eligible for Study
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Minimum Age: 20 Years
Maximum Age: 70 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: A:phaco+MP-TSCPC<br>22 patients with primary angle closure glaucoma will undergo phacoemulsification and micropulse cyclophotocoagulation | Procedure: phaco+MP-TSCPC<br>* The procedure starts with performing the cyclophotocoagulation using the Micropulse P3 device (IQ 810 Laser Systems; Iridex, Mountain View, CA, USA) at 2500 mW with a duration of 90 seconds in each hemisphere at a 31.3% duty cycle under local anesthesia and then performing phacoemulsification and IOL implantation.<br>|
| Experimental: B:phaco+TSCPC<br>22 patients with primary angle closure glaucoma will undergo phaco and transscleral cyclophotocoagulation | Procedure: phaco+TSCPC<br>* The procedure starts with performing the cyclophotocoagulation using the IRIDEX's G probe device (IRIDEX Corp. Mountain View, CA, USA) at 1500 to2000 mW with a duration of 1500 ms applying about 15 shots in one hemisphere only under local anesthesia and then performing phacoemulsification and IOL implantation.<br>|
| Experimental: C:phaco+endocyclophotocoagulation<br>22 patients with primary angle closure glaucoma will undergo phaco and endocyclophotocoagulation after cataract removal | Procedure: phaco+endocyclophotocoagulation<br>* phacoemulsification will be done and endocyclophotocoagulation will be done after cataract extraction<br>|
| Experimental: D:phaco GSL<br>22 patients with primary angle closure glaucoma will undergo phaco and goniosynechiolysis | Procedure: phaco GSL<br>* phacoemulsification will be done and then the angle is visualized by direct goniolens then the synechia are dissected by cohesive viscoelastic.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| the percentage of intraocular pressure change | measuring the intraocular pressure after 1M, 3M and 6M | 6 Months | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| percent change of antiglaucoma medications | the number of medication before and after the procedure | 6 Months | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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angle closure glaucoma, cyclophotocoagulation