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Abstract #15191 Published in IGR 8-4
Phaco-viscocanalostomy versus phaco-trabeculotomy: a middle-term study
Park M; Hayashi K; Takahashi H; Tanito M; Chihara EJournal of Glaucoma 2006; 15: 456-461
PURPOSE: To compare the surgical outcomes between phaco-viscocanalostomy and phaco-trabeculotomy in open-angle glaucoma. PATIENTS AND METHODS: In a nonrandomized, retrospective clinical study, 110 eyes underwent phaco-viscocanalostomy (VCS group), and 110 eyes underwent phaco-trabeculotomy (LOT group). The mean follow-up was 857 ± 409 (± SD) days (P = 0.4777). RESULTS: The mean preoperative treated intraocular pressure (IOP) values were 20.2 ± 3.5 mmHg in the VCS group and 20.9 ± 3.5 mmHg in the LOT group (P=0.3377). The postoperative IOPs in the VCS group were 15.0 ± 3.0 and 16.1 ± 3.0 mmHg at 1 and 3 years, and in the LOT group 16.3 ± 2.9 mmHg (P = 0.0088) and 16.5 ± 3.3 mmHg (P = 0.4993), respectively. The number of medications used in the VCS group was significantly lower than in the LOT group during the observation periods (P ≤ 0.0130). The probabilities of achieving IOPs ≤ 21 mmHg at 3 years in the VCS group were 92.0% with or without mediations and 58.2% without medications, and were significantly better than those of the LOT group (84.7% and 36.0%, P = 0.0334 and P < 0.0001 by log-rank test, respectively). The probabilities of achieving IOPs ≤ 16 mmHg at 3 years in the VCS group were 30.5% with or without mediations and 30.3% without medications, whereas those in the LOT group were 27.5% (P = 0.1799) and 19.4% (P = 0.0010), respectively. The visual outcome was similar between the groups. Postoperative hyphema (≥ 2 mm) and IOP spikes (≥ 30 mmHg) occurred significantly less in the VCS group (2.7 and 3.6%, respectively) than in the LOT group (26.4 and 28.2%, respectively; P < 0.0001). In 13 eyes (11.8%) of the LOT group, the highest IOP level was recorded 40 mmHg or higher. Vitreous hemorrhage and central visual loss occurred in 1 case each in the LOT group. CONCLUSIONS: After a middle-term observation, phaco-viscocanalostomy provides better IOP control and a lower incidence of vision-threatening complications than phaco-trabeculotomy.
Dr. M. Park, Sensho-kai Eye Institute, Kyoto, Japan
Classification:
12.8.3 Non-perforating (Part of: 12 Surgical treatment > 12.8 Filtering surgery)
12.9 Trabeculotomy, goniotomy (Part of: 12 Surgical treatment)
12.14.3 Phacoemulsification (Part of: 12 Surgical treatment > 12.14 Combined cataract extraction and glaucoma surgery)
