{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,18]],"date-time":"2026-05-18T05:06:29Z","timestamp":1779080789746,"version":"3.51.4"},"reference-count":34,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,5,18]],"date-time":"2026-05-18T00:00:00Z","timestamp":1779062400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>To evaluate the short-term effectiveness and safety of Phacoemulsification with intraocular lens implantation combined with goniosynechialysis and goniotomy (PEI-GSL-GT) in eyes with prior failed trabeculectomy compared to surgically na\u00efve eyes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and methods<\/jats:title>\n                    <jats:p>This retrospective study enrolled 40 eyes (34 patients) diagnosed with moderate to advanced primary angle-closure glaucoma (PACG) who received treatment at the Eye Hospital of Nanjing Medical University from November 2024 to November 2025. After excluding one patient lost to follow-up, 39 eyes (33 patients) with at least 3 months of follow-up were finally included. Among them, 17 cases underwent reoperation due to previous trabeculectomy failure, while 22 cases received the surgical intervention for the first time. All eyes underwent the PEI-GSL-GT procedure. The cohort was divided into a Na\u00efve Group (no prior glaucoma surgery) and a Trabeculectomy failure group (prior failed trabeculectomy). Main outcome measures included intraocular pressure (IOP), best-corrected visual acuity (BCVA), the number of anti-glaucoma medications, and postoperative complications. Surgical success was analyzed using Kaplan-Meier survival curves.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Baseline characteristics were comparable between the Na\u00efve (\n                      <jats:italic>n<\/jats:italic>\n                      = 22) and Trabeculectomy failure (\n                      <jats:italic>n<\/jats:italic>\n                      = 17) groups (\n                      <jats:italic>P<\/jats:italic>\n                      &amp;gt; 0.05). At 3 months, mean IOP decreased significantly in both groups (Na\u00efve: 22.05\u201314.62 mmHg,\n                      <jats:italic>P<\/jats:italic>\n                      = 0.002; Trabeculectomy failure group: 24.53 to 17.00 mmHg,\n                      <jats:italic>P<\/jats:italic>\n                      = 0.035), with no significant between-group differences (\n                      <jats:italic>P<\/jats:italic>\n                      &amp;gt; 0.05). Medication burden was significantly reduced in both cohorts. Exploratory Kaplan-Meier analysis showed no significant difference in short-term cumulative success (Log-rank\n                      <jats:italic>P<\/jats:italic>\n                      = 0.750). Safety profiles were comparable with no vision-threatening complications. BCVA improved in the Na\u00efve Group (\n                      <jats:italic>P<\/jats:italic>\n                      &amp;lt; 0.001) and the Trabeculectomy failure group (\n                      <jats:italic>P<\/jats:italic>\n                      = 0.177).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>PEI-GSL-GT was associated with significant IOP reduction and reduced medication burden during short-term follow-up. No statistically significant differences were observed between the Trabeculectomy failure group and Na\u00efve groups in most outcomes during the 3-month follow-up.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fmed.2026.1842636","type":"journal-article","created":{"date-parts":[[2026,5,18]],"date-time":"2026-05-18T04:18:07Z","timestamp":1779077887000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Phacoemulsification with IOL implantation combined with goniosynechialysis and goniotomy in primary angle-closure glaucoma following failed trabeculectomy: short-term effectiveness and safety outcomes"],"prefix":"10.3389","volume":"13","author":[{"given":"Lujia","family":"Zhou","sequence":"first","affiliation":[{"name":"The Affiliated Eye Hospital, Nanjing Medical University, Nanjing","place":["Jiangsu, China"]},{"name":"The Fourth School of Clinical Medicine, Nanjing Medical University","place":["Nanjing, 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China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Li","family":"Tang","sequence":"additional","affiliation":[{"name":"The Affiliated Eye Hospital, Nanjing Medical University, Nanjing","place":["Jiangsu, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Weiling","family":"Yan","sequence":"additional","affiliation":[{"name":"The Affiliated Eye Hospital, Nanjing Medical University, Nanjing","place":["Jiangsu, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Qing","family":"Li","sequence":"additional","affiliation":[{"name":"The Affiliated Eye Hospital, Nanjing Medical University, Nanjing","place":["Jiangsu, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cheng","family":"Lai","sequence":"additional","affiliation":[{"name":"The Affiliated Eye Hospital, Nanjing Medical University, Nanjing","place":["Jiangsu, 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