Randomized comparison of the intraocular pressure-lowering effect of phacoviscocanalostomy and phacotrabeculectomy.
OBJECTIVE
To compare the intraocular pressure (IOP)-lowering effect of combined viscocanalostomy and phacoemulsification and combined trabeculectomy and phacoemulsification with mitomycin C in eyes with primary open-angle glaucoma.


METHODS
Prospective randomized 1-year trial.


METHODS
Forty consecutive patients (40 eyes) with primary open-angle glaucoma and cataract.


METHODS
Eyes were assigned randomly either to trabeculectomy with mitomycin C or to viscocanalostomy in combination with phacoemulsification and intraocular lens implantation.


METHODS
Success rate based on IOP.


RESULTS
Mean baseline IOP was 24.0+/-2.0 mmHg in the viscocanalostomy group and 23.7+/-2.6 mmHg in the trabeculectomy group (P = 0.7). Mean postoperative IOP was 13.7+/-2.2 mmHg at 3 months, 14.8+/-3.3 mmHg at 6 months, and 14.9+/-3.0 mmHg at 12 months in the viscocanalostomy group and 12.1+/-4.0 mmHg at 3 months, 13.8+/-4.7 mmHg at 6 months, and 14.1+/-4.4 mmHg at 12 months in the trabeculectomy group. There was no significant difference in the mean IOP between the groups at any time. At 12 months, 17 patients (85%) in the viscocanalostomy group and 16 patients (80%) in the trabeculectomy group achieved an IOP of 20 mmHg or less without medication (P = 0.7). Complications included 2 cases (10%) of flat/shallow anterior chamber and 4 cases (20%) of hypotony in the trabeculectomy group, whereas intraoperative microperforation of Descemet's membrane occurred in 3 cases (15%) in the viscocanalostomy group.


CONCLUSIONS
There was no significant difference in IOP reduction between viscocanalostomy and trabeculectomy with mitomycin C in combination with phacoemulsification and intraocular lens implantation in patients with primary open-angle glaucoma.
Kobayashi
Hiroshi
H
Department of Ophthalmology, Faculty of Medicine, Saga University, Saga, Japan. kobi@earth.ocn.ne.jp
Kobayashi
Kaori
K
D000368:Aged; D000369:Aged, 80 and over; D000477:Alkylating Agents / Q000008:administration & dosage; D002386:Cataract / Q000150:complications / Q000503:physiopathology / Q000628:therapy*; D002404:Catheterization; D002908:Chronic Disease; D005260:Female; D005902:Glaucoma, Open-Angle / Q000150:complications / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D007429:Intraocular Pressure / Q000502:physiology*; D019654:Lens Implantation, Intraocular; D008297:Male; D008875:Middle Aged; D016685:Mitomycin / Q000008:administration & dosage; D018918:Phacoemulsification / Q000379:methods*; D011446:Prospective Studies; D013524:Surgical Flaps; D013536:Suture Techniques; D014065:Tonometry, Ocular; D014130:Trabeculectomy / Q000379:methods*; D016896:Treatment Outcome; D014792:Visual Acuity / Q000502:physiology; D014794:Visual Fields / Q000502:physiology
D000477:Alkylating Agents; D016685:Mitomycin