title: Comparison of surgical outcomes of combined viscocanalostomy and cataract surgery with combined trabeculotomy and cataract surgery.
abstract: OBJECTIVE
  To compare the outcomes of combined viscocanalostomy, phacoemulsification, and intraocular lens (IOL) implantation with combined trabeculotomy, phacoemulsification, and IOL implantation in patients with primary open-angle glaucoma (POAG).
  
  
  METHODS
  Nonrandomized clinical trial.
  
  
  METHODS
  Fifty-seven eyes (57 POAG patients) that underwent viscocanalostomy, phacoemulsification, and intraocular lens (IOL) implantation between March 2000 and April 2001 and were followed for over 6 months postoperatively comprised the viscocanalostomy (VCS) group. Fifty-seven of 105 eyes (105 POAG patients) that underwent trabeculotomy, phacoemulsification, and IOL implantation between April 1995 and February 2000 and were followed for over 6 months and < 2 years comprised the trabeculotomy (LOT) group. The reductions of postoperative intraocular pressure (IOP) and antiglaucoma medication use in both groups were compared. Best-corrected visual acuity (VA) and complication rates were secondary outcomes. The success probabilities related to postoperative IOP level in both groups were evaluated by Kaplan-Meier life-table analysis with log-rank test.
  
  
  RESULTS
  Significant reductions of IOP and antiglaucoma medication use occurred in both groups up to 1 year postoperatively, but were not significantly different between the two groups. The success probabilities of the VCS group for IOP control under 21, 17, and 15 mm Hg were 95%, 74%, and 44%, respectively, at 6 months, 95%, 67%, and 32% at 1 year, and not significantly different from the LOT group. All eyes in the VCS group had VA equal to or better than baseline 3 months postoperatively. The incidences of postoperative fibrin reaction (14 eyes, 25%) and microperforations of the Descemet membrane (14 eyes, 25%) in the VCS group were higher than in the LOT group (P =.0004 and P <.0001, respectively).
  
  
  CONCLUSIONS
  Intraocular pressure reduction and VA improvement after the two procedures were similar in Japanese patients with POAG and cataract.
authors.affiliation: Senshokai Eye Institute, Kyoto, Japan. mtanito@virus.kyoto-u.ac.jp
authors.forename: Masaki
authors.initials: M
authors.lastname: Tanito
authors.forename: Masami
authors.initials: M
authors.lastname: Park
authors.forename: Maki
authors.initials: M
authors.lastname: Nishikawa
authors.forename: Akihiro
authors.initials: A
authors.lastname: Ohira
authors.forename: Etsuo
authors.initials: E
authors.lastname: Chihara
mesh_terms: D002387:Cataract Extraction / Q000009:adverse effects; D003886:Descemet Membrane / Q000601:surgery*; D005902:Glaucoma, Open-Angle / Q000188:drug therapy / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D006820:Hyaluronic Acid / Q000008:administration & dosage* / Q000627:therapeutic use; D007267:Injections; D007429:Intraocular Pressure; D007910:Lenses, Intraocular; D018918:Phacoemulsification; D011446:Prospective Studies; D014130:Trabeculectomy / Q000009:adverse effects; D016896:Treatment Outcome; D014792:Visual Acuity
chemical_list: D006820:Hyaluronic Acid