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Purpose . To report one-year results of phacoemulsification combined with deep sclerectomy and goniosynechiolysis ab interno for chronic glaucoma associated with peripheral anterior synechiae (PAS).  Methods . We retrospectively analyzed medical charts of 16 patients (20 eyes) treated by one-site combined phacoemulsification and deep sclerectomy with goniosynechiolysis ab interno. PAS were transected by a spatula introduced into the anterior chamber through a paracentesis. To account for the correlation of right and left eyes a linear mixed model with unstructured covariance structure was calculated.  Results . The mean preoperative intraocular pressure (IOP) was 20.3 ± 5.2 mmHg with 2.4 ± 1.0 medications. One year postoperatively, the mean IOP was 15.3 ± 3.3 mmHg ( P  = 0.004, paired  t -test) with 0.6 ± 1.0 medications. A postoperative IOP of ≤21 mmHg without medication was achieved in 17 of 19 eyes (89.5%) and in 12/19 eyes (63.2%) at 3 and 12 months after surgery, respectively. In the remaining eyes (10.5% at 3 months and 36.8% at 12 months), additional medication led to an IOP ≤21 mmHg or the target pressure. No case required further glaucoma surgery. In one eye, conversion of the surgery to trabeculectomy was necessary due to Descemet's window rupture.  Conclusions . With goniosynechiolysis ab interno, effective and safe nonpenetrating glaucoma surgery is possible in presence of PAS.

Deep Sclerectomy with Goniosynechiolysis Ab Interno for Chronic Glaucoma Associated with Peripheral Anterior Synechiae