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Abstract #9065 Published in IGR 5-2
A comparison of the intraocular pressure-lowering effect and safety of viscocanalostomy and trabeculectomy with mitomycin C in bilateral open-angle glaucoma
Kobayashi H; Kodayashi K; Okinami SGraefe's Archive for Clinical and Experimental Ophthalmology 2003; 241: 359-366
PURPOSE: To compare the intraocular pressure (IOP)-lowering effect and safety of viscocanalostomy and trabeculectomy with mitomycin C. METHODS: Twenty-five patients with bilateral primary open-angle glaucoma (POAG) were enrolled in a prospective clinical study. The eyes of each patient were randomly assigned to receiving viscocanalostomy in one eye and trabeculectomy with mitomycin C in the other. The patients were followed up for 12 months. At each visit, best-corrected visual acuity, IOP, and the appearance of the surgical wound, anterior chamber, and indirect ophthalmoscopy were recorded. RESULTS: The mean baseline IOP was 25.0 ± 2.2 mmHg in viscocanalostomy-treated eyes and 24.8 ± 2.6 mmHg in trabeculectomy-treated eyes. The mean postoperative IOP was 15.3 ± 1.7, 17.1 ± 1.5, and 17.1 ± 1.5 mmHg in viscocanalostomy-treated eyes and 11.7 ± 4.4, 11.8 ± 4.6, and 12.6 ± 4.3 mmHg in trabeculectomy-treated eyes at three-, six-, and 12-month intervals, respectively. The mean IOP in viscocanalostomy-treated eyes was significantly higher than that in trabeculectomy-treated eyes at all visits (p < 0.0001). At 12 months, 16 viscocanalostomy-treated eyes (64%) and 22 trabeculectomy-treated eyes (88%) achieved an IOP of ≤ 20 mmHg without medication; there was a significant difference between the two groups (p = 0.0240). There were fewer complications in viscocanalostomy-treated eyes. Complications included four cases of shallow anterior chamber (16%) and five of hypotony (20%) in trabeculectomy-treated eyes, against intraoperative microperforation of Descemet's membrane in one of the viscocanalostomy-treated eyes (4%). CONCLUSIONS: Trabeculectomy with mitomycin C may be more effective than viscocanalostomy in lowering IOP in patients with POAG, while eyes undergoing viscocanalostomy experience a lower incidence of complications. Further investigation of more cases is needed.
Dr. H. Kobayashi, Department of Ophthalmology, Saga Medical School, 5-1-1 Nabeshima, 849-8501 Saga, Japan. kobayas3@post.saga-med.ac.jp
Classification:
12.8.3 Non-perforating (Part of: 12 Surgical treatment > 12.8 Filtering surgery)
12.8.10 Woundhealing antifibrosis (Part of: 12 Surgical treatment > 12.8 Filtering surgery)
