Phaco-viscocanalostomy versus phaco-trabeculotomy: a middle-term study.
OBJECTIVE
To compare the surgical outcomes between phaco-viscocanalostomy and phaco-trabeculotomy in open-angle glaucoma.


METHODS
In a nonrandomized, retrospective clinical study, 110 eyes underwent phaco-viscocanalostomy (VCS group), and 110 eyes underwent phaco-trabeculotomy (LOT group). The mean follow-up was 857+/-409 (+/-SD) days (P=0.4777).


RESULTS
The mean preoperative treated intraocular pressure (IOP) values were 20.2+/-3.5 mm Hg in the VCS group and 20.9+/-3.5 mm Hg in the LOT group (P=0.3377). The postoperative IOPs in the VCS group were 15.0+/-3.0 and 16.1+/-3.0 mm Hg at 1 and 3 years, and in the LOT group 16.3+/-2.9 mm Hg (P=0.0088) and 16.5+/-3.3 mm Hg (P=0.4993), respectively. The number of medications used in the VCS group was significantly lower than in the LOT group during the observation periods (P< or =0.0130). The probabilities of achieving IOPs< or =21 mm Hg at 3 years in the VCS group were 92.0% with or without mediations and 58.2% without medications, and were significantly better than those of the LOT group (84.7% and 36.0%, P=0.0334 and P<0.0001 by log-rank test, respectively). The probabilities of achieving IOPs< or =16 mm Hg at 3 years in the VCS group were 30.5% with or without mediations and 30.3% without medications, whereas those in the LOT group were 27.5% (P=0.1799) and 19.4% (P=0.0010), respectively. The visual outcome was similar between the groups. Postoperative hyphema (> or =2 mm) and IOP spikes (> or =30 mm Hg) occurred significantly less in the VCS group (2.7 and 3.6%, respectively) than in the LOT group (26.4 and 28.2%, respectively; P<0.0001). In 13 eyes (11.8%) of the LOT group, the highest IOP level was recorded 40 mm Hg or higher. Vitreous hemorrhage and central visual loss occurred in 1 case each in the LOT group.


CONCLUSIONS
After a middle-term observation, phaco-viscocanalostomy provides better IOP control and a lower incidence of vision-threatening complications than phaco-trabeculotomy.
Park
Masami
M
Sensho-kai Eye Institute, Kyoto, Japan.
Hayashi
Ken
K
Takahashi
Hirokazu
H
Tanito
Masaki
M
Chihara
Etsuo
E
D000368:Aged; D000369:Aged, 80 and over; D002386:Cataract / Q000150:complications / Q000628:therapy*; D017889:Exfoliation Syndrome / Q000150:complications / Q000601:surgery; D005260:Female; D018463:Filtering Surgery / Q000379:methods; D005500:Follow-Up Studies; D005902:Glaucoma, Open-Angle / Q000150:complications / Q000601:surgery*; D006801:Humans; D007429:Intraocular Pressure; D008297:Male; D008875:Middle Aged; D009798:Ocular Hypertension / Q000150:complications / Q000601:surgery; D018918:Phacoemulsification / Q000379:methods*; D012189:Retrospective Studies; D013524:Surgical Flaps; D014065:Tonometry, Ocular; D014130:Trabeculectomy / Q000379:methods*; D016896:Treatment Outcome