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Updated: Jul 5, 2026

Iris Fixation via External Pentagram Suturing
Published on: May 5, 2022
Primary phacoemulsification and aspiration combined with 25-gauge single-port vitrectomy for management of acute
1Wakayama Red Cross Medical Center, Wakayama - Japan. mshinji@pop17.odn.ne.jp
Purpose:
To describe a technique using phacoemulsification and aspiration (PEA) combined with 25-gauge single-port vitrectomy as a primary treatment for acute angle closure (AAC).
Methods:
Seventeen consecutive cases of AAC were treated with 1) transconjunctival limited single-port vitrectomy with a 25-gauge vitrector and 2) transcorneal PEA and cortex removal followed by implantation of foldable intraocular lenses (IOL).
Results:
Intraocular pressure (IOP) control was achieved in all 17 eyes examined. Mean preoperative IOP was 51.8+/-13.1 mmHg, and mean IOP on postoperative day 1 was 18.3+/-8.5 mmHg. Additional anti-glaucoma surgery was necessary in one eye. IOL could not be implanted because of zonular dialysis in one eye. Postoperative complications were seen in three cases (one retinal hemorrhage and two papilledema).
Conclusions:
The PEA procedure is efficient as a primary treatment of AAC. Single-port vitrectomy with a 25-gauge vitrector facilitated PEA and IOL implantation.
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