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Abstract #18168 Published in IGR 9-2
Randomized comparison of the intraocular pressure-lowering effect of phacoviscocanalostomy and phacotrabeculectomy
Kobayashi H; Kobayashi KOphthalmology 2007; 114: 909-914
PURPOSE: To compare the intraocular pressure (IOP)-lowering effect of combined viscocanalostomy and phacoemulsification and combined trabeculectomy and phacoemulsification with mitomycin C in eyes with primary open-angle glaucoma. DESIGN: Prospective randomized 1-year trial. PARTICIPANTS: Forty consecutive patients (40 eyes) with primary open-angle glaucoma and cataract. INTERVENTION: Eyes were assigned randomly either to trabeculectomy with mitomycin C or to viscocanalostomy in combination with phacoemulsification and intraocular lens implantation. MAIN OUTCOME MEASURES: Success rate based on IOP. RESULTS: Mean baseline IOP was 24.0 ± 2.0 mmHg in the viscocanalostomy group and 23.7 ± 2.6 mmHg in the trabeculectomy group (P = 0.7). Mean postoperative IOP was 13.7 ± 2.2 mmHg at 3 months, 14.8 ± 3.3 mmHg at 6 months, and 14.9 ± 3.0 mmHg at 12 months in the viscocanalostomy group and 12.1 ± 4.0 mmHg at 3 months, 13.8 ± 4.7 mmHg at 6 months, and 14.1 ± 4.4 mmHg at 12 months in the trabeculectomy group. There was no significant difference in the mean IOP between the groups at any time. At 12 months, 17 patients (85%) in the viscocanalostomy group and 16 patients (80%) in the trabeculectomy group achieved an IOP of 20 mmHg or less without medication (P = 0.7). Complications included 2 cases (10%) of flat/shallow anterior chamber and 4 cases (20%) of hypotony in the trabeculectomy group, whereas intraoperative microperforation of Descemet's membrane occurred in three cases (15%) in the viscocanalostomy group. CONCLUSIONS: There was no significant difference in IOP reduction between viscocanalostomy and trabeculectomy with mitomycin C in combination with phacoemulsification and intraocular lens implantation in patients with primary open-angle glaucoma.
Dr. H. Kobayashi, Department of Ophthalmology, Faculty of Medicine, Saga University, Saga, Japan. kobi@earth.ocn.ne.jp
Classification:
12.14.3 Phacoemulsification (Part of: 12 Surgical treatment > 12.14 Combined cataract extraction and glaucoma surgery)
12.8.1 Without tube implant (Part of: 12 Surgical treatment > 12.8 Filtering surgery)
12.8.10 Woundhealing antifibrosis (Part of: 12 Surgical treatment > 12.8 Filtering surgery)