Treatment Overview
Goniosynechialysis (GSL) in Korea is a specialized Minimally Invasive Glaucoma Surgery (MIGS) technique used to restore normal aqueous outflow by breaking abnormal adhesions between the iris and the trabecular meshwork called peripheral anterior synechiae (PAS). These adhesions commonly occur in angle-closure or mixed-mechanism glaucoma and can significantly block the drainage angle.
Korean ophthalmology centers perform GSL using high-definition gonioscopy, OCT-guided angle imaging, micro-incision instrumentation, viscodissection, and AI-assisted adhesion mapping, allowing surgeons to separate the synechiae with exceptional precision and minimal trauma. This restores the natural configuration of the angle and reopens the outflow pathways, often dramatically lowering intraocular pressure (IOP).
GSL is frequently performed alone or combined with cataract surgery and other MIGS procedures for optimal pressure control.
Purpose & Benefits
Purpose
- Remove peripheral anterior synechiae that obstruct the drainage angle.
- Reopen the trabecular meshwork and Schlemm’s canal to improve natural aqueous humor outflow.
- Treat angle-closure or plateau iris–related glaucoma safely and effectively.
- Reduce the need for long-term glaucoma medications.
Benefits
- Restores Natural Anatomy: Reopens the drainage angle without implants or tissue removal.
- Highly Effective for Angle-Closure Glaucoma: One of the best treatments for PAS-related blockages.
- Minimally Invasive: Performed through a small corneal incision.
- Fast Recovery: Low inflammation and rapid visual restoration.
- Medication Reduction: Many patients decrease or discontinue glaucoma drops.
- Can Be Combined with Cataract Surgery: Enhances long-term outcomes.
Ideal Candidates
Goniosynechialysis in Korea is ideal for:
- Patients with chronic or acute angle-closure glaucoma.
- Individuals with PAS obstructing trabecular outflow.
- Patients whose angles remain narrow despite laser iridotomy.
- Those with plateau iris configuration.
- Individuals undergoing cataract surgery, especially in angle-closure cases.
- Patients looking for a minimally invasive alternative to filtering surgery.
Possible Risks & Complications
GSL is considered very safe, but mild issues may occur:
- Small hyphema (blood reflux; usually resolves quickly)
- Transient inflammation
- Mild postoperative discomfort
- Temporary IOP fluctuations
- Rare reformation of synechiae
Korean surgeons reduce risks using:
- AI-guided adhesion mapping
- High-definition gonioscopes
- OCT-based angle visualization
- Micro-precision dissection instruments
- Postoperative anti-scarring protocols
Surgical Techniques
AI-Based Synechiae Mapping
Analyzes the extent, height, and density of PAS for targeted dissection.
Micro-Incision Access
A small corneal incision allows access to the drainage angle.
Mechanical Synechiae Separation
Micro-instruments gently peel and separate the iris from the trabecular meshwork.
Viscodissection (Optional)
Viscoelastic material is injected to hydraulically break adhesions safely.
OCT-Guided Angle Confirmation
Ensures complete and precise opening of the drainage angle.
Combined MIGS Strategies
Frequently combined with cataract surgery, KDB, canaloplasty, or SLT to improve long-term success.
Treatment Process in Korea
Step-by-Step Workflow
Step 1 – Comprehensive Assessment
Includes gonioscopy, OCT angle imaging, IOP measurement, visual field testing, and PAS extent analysis.
Step 2 – Surgical Planning
AI tools determine adhesion severity and optimal dissection strategy.
Step 3 – Micro-Incision Entry
A small corneal incision provides access to angle structures.
Step 4 – Goniosynechialysis Procedure
The surgeon uses mechanical or visco-assisted methods to separate PAS and reopen the drainage angle.
Step 5 – Postoperative Monitoring
Regular evaluations confirm angle stability and IOP control.
Treatment Duration: 10–15 minutes per eye
Setting: Outpatient or combined with cataract surgery
Recovery & After-Care
After-Care Guidelines
- Use antibiotic and anti-inflammatory drops for 1–2 weeks.
- Avoid heavy exercise, eye rubbing, and water exposure for several days.
- Wear protective sunglasses outdoors.
- Continue glaucoma medications until advised to taper.
- Attend follow-up visits at Day 1, Week 1, and Month 1.
Recovery Timeline
Days 1–3: Mild discomfort, slight redness, and early IOP reduction.
Week 1: Good angle opening and stabilized vision.
Weeks 2–4: Clear improvement in drainage and decreased medication reliance.
1–3 Months: Long-term stabilization and restored angle function.
Results & Longevity
Expected Results
- Significant reopening of the drainage angle.
- Noticeable reduction in IOP.
- Improved natural aqueous outflow through the trabecular meshwork.
- Reduced dependence on medications.
- Long-term stability when combined with cataract surgery or other MIGS.
Longevity
- GSL provides long-lasting IOP control, especially when performed early.
- Angle stability improves further when combined with lens extraction.
- Korean clinics enhance durability through image-guided precision and anti-fibrotic care.
Why Korea Is a Top Destination
- Leading Experts in Angle-Closure Glaucoma: Korean surgeons specialize in PAS-related interventions.
- Advanced Imaging Technology: OCT angle scanning provides unmatched precision.
- AI-Assisted Planning: Ensures optimal dissection strategy for each patient.
- Minimally Invasive Approach: Reduced trauma and fast recovery.
- Exceptional Success Rates: High effectiveness in restoring natural outflow pathways.
Unique Korean Innovations
- AI-driven synechiae mapping and segmentation.
- OCT-guided verification of angle reopening.
- Viscodissection protocols optimized for safety.
- Combination MIGS (GSL + KDB, GSL + canaloplasty, GSL + SLT).
- Advanced postoperative anti-scarring management.
These advancements make Goniosynechialysis in Korea one of the most effective and precise MIGS options for treating angle-closure glaucoma and PAS-related outflow obstruction.
Cost Range (Indicative Estimate)
| Treatment Package | Price (KRW) | Approx. USD | Inclusions |
|---|---|---|---|
| Standard Goniosynechialysis | ₩900,000 – ₩1,500,000 | ~$700 – $1,150 | Mechanical or visco-assisted GSL with basic follow-up |
| Premium OCT-Guided GSL Package | ₩1,800,000 – ₩2,800,000 | ~$1,350 – $2,100 | AI planning, OCT imaging, enhanced angle visualization |
| Hybrid MIGS Combination Program | ₩3,000,000 – ₩5,000,000+ | ~$2,300 – $3,800+ | GSL + MIGS (KDB, ELT, canaloplasty, etc.) for maximal effect |
Pricing varies depending on surgeon expertise, technology level, and combined procedures.
Popular Clinics in Korea
- B&VIIT Eye Center (Seoul): Leading specialists in angle-closure management and GSL.
- Dream Eye Center (Seoul): Known for OCT-guided precision and combined MIGS strategies.
- BGN Eye Clinic (Seoul & Busan): Experts in hybrid GSL with advanced MIGS techniques.
- Glory Seoul Eye Clinic: Excels in delicate synechiae separation with high success rates.
- K-Cure Vision Center (Gangnam): Leaders in AI-assisted angle imaging and minimally invasive glaucoma surgery.
