Gonio-synechiolysis using the irrigation/aspiration probe is a useful adjunct during cataract surgery in eyes with acute angle closure glaucoma and peripheral anterior synechiae (PAS). After phacoemulsification and cortical cleanup, the IOL is placed in the capsular bag. The IA probe is then used to gently engage and sweep the PAS at the angle, typically starting inferiorly. With controlled aspiration and irrigation, the probe mechanically separates the iris from the trabecular meshwork, breaking the synechiae without causing bleeding or damage to adjacent structures. This restores access to the angle for aqueous outflow and may prevent future intraocular pressure spikes. The technique is effective when PAS are not chronically fibrotic and allows for anatomical angle restoration during a single surgical session. Careful manipulation and visualization are essential to avoid iris trauma or hyphema. Gonio-synechiolysis with the IA probe is both safe and effective in select acute angle closure cases. Have you tried this technique?
