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Abstract #21215 Published in IGR 10-2
Phacoviscocanalostomy
Park M; Chihara ETechniques in Ophthalmology 2008; 6: 1-4
Viscocanalostomy is a nonpenetrating glaucoma surgery proposed by Stegmann et al in the 1990s. The surgery consists of unroofing of the Schlemm canal, preparing a thin trabeculo-Descemet membrane, and injecting a high-molecular weight viscoelastic material into the Schlemm canal and the intrascleral 'lake'. The procedure lowers the intraocular pressure by internal drainage and does not produce a persistent bleb. There are no vision-threatening complications. Combined cataract and viscocanalostomy, that is, phacoviscocanalostomy, produces a greater hypotensive effect compared with viscocanalostomy alone. A randomized controlled trial recently showed that there was no significant difference in the intraocular pressure-lowering effects between phacoviscocanalostomy and phacotrabeculectomy for 1 year. Descemet membrane-related complications, that is, microperforation and iris prolapse, can occur during the procedure, especially when performed by surgeons inexperienced with the procedure. Phacoviscocanalostomy is a new beneficial surgery for elderly patients with glaucoma, although it has an associated learning curve to master.
Dr. M. Park, Sensho-kai Eye Institute, Minamiyama 50-1, Iseda, Uji, Kyoto, 611-0043, Japan. mpark@belle.shiga-med.ac.jp
Classification:
12.14.3 Phacoemulsification (Part of: 12 Surgical treatment > 12.14 Combined cataract extraction and glaucoma surgery)