The goal of this clinical trial is to learn whether phacoemulsification combined with goniosynechialysis (Phaco-GSL) is as effective and safe as trabeculectomy in treating patients with primary angle-closure glaucoma.
The main questions it aims to answer are:
* Does Phaco-GSL provide similar or better intraocular pressure (IOP) control compared to trabeculectomy? * What are the rates of postoperative complications or adverse events between the two surgical approaches? * How do the two procedures compare in terms of visual acuity recovery and need for glaucoma medications?
Researchers will compare Phaco-GSL to trabeculectomy to determine which procedure offers better overall outcomes for patients with angle-closure glaucoma.
Participants will:
Be randomly assigned to undergo either Phaco-GSL or trabeculectomy Attend scheduled follow-up visits at regular intervals (e.g., 1 week, 1 month, 3 months, 6 months, 12 months) for eye exams and pressure checks
Age ≥ 40 years
Peripheral anterior synechiae (PAS) >180°
Glaucomatous optic neuropathy with visual field loss
Intraocular pressure (IOP) > 21 mmHg despite medication
Very advanced glaucoma (only light perception vision)
Secondary angle-closure etiologies
Prior ocular surgeries or laser peripheral iridotomy (PI)
Allergy to 5-fluorouracil (5-FU), if used postoperatively