title: Viscocanalostomy versus trabeculectomy in patients with bilateral high-tension glaucoma.
abstract: Results of trabeculectomy (TE) and viscocanalostomy (VCO) were compared in a prospective randomised study in two fellow eyes of 22 consecutive patients with bilateral symmetrical high-tension glaucoma. Rates of overall surgical success with intraocular pressures (IOP) < or = 18 mm Hg with or without medications were 91 for the TE, and 95 for the VCO group after a mean follow-up of 18 months. Complete success rates without medications were 64 and 59 for TE and VCO groups, respectively (p = 0.750). Both procedures significantly reduced IOP, however, IOP course following trabeculectomy was significantly lower (p = 0.026). Rates of complications were not found to be different between the two groups of eyes, except for an apparent--though not significant (p = 0.066)--increase in cataract progression with TE. Various types of conjunctival blebs were detected in all eyes with surgical success in both groups, however, diffuse, elevated or multi-cystic functional blebs appeared to be more predominant in eyes with TE, compared to the VCO group in which low-lying, localised blebs had a higher incidence (p = 0.015). Viscocanalostomy was found to be a safe and effective filtration technique in patients with uncomplicated high-tension glaucoma, though IOP decrease was more pronounced with trabeculectomy.
authors.affiliation: 1st Eye Clinic, Ankara Numune Training and Research Hospital, Ankara, Turkey. alperyx@yahoo.com
authors.forename: Alper
authors.initials: A
authors.lastname: Yarangümeli
authors.forename: Serkan
authors.initials: S
authors.lastname: Güreser
authors.forename: Ozlem Gürbüz
authors.initials: OG
authors.lastname: Köz
authors.forename: Atilla Halil
authors.initials: AH
authors.lastname: Elhan
authors.forename: Gülcan
authors.initials: G
authors.lastname: Kural
mesh_terms: D000328:Adult; D000368:Aged; D001768:Blister / Q000453:epidemiology / Q000209:etiology; D002386:Cataract / Q000503:physiopathology; D003229:Conjunctival Diseases / Q000453:epidemiology / Q000209:etiology; D018450:Disease Progression; D005260:Female; D018463:Filtering Surgery / Q000009:adverse effects / Q000379:methods*; D005901:Glaucoma / Q000503:physiopathology* / Q000601:surgery*; D006801:Humans; D015994:Incidence; D007429:Intraocular Pressure; D008297:Male; D008875:Middle Aged; D011184:Postoperative Period; D012590:Sclera / Q000601:surgery*; D014130:Trabeculectomy / Q000009:adverse effects; D016896:Treatment Outcome