Bimanual microincisional phacoemulsification combined with viscocanalostomy plus deeper sclerectomy.
OBJECTIVE
The aim of the study was to evaluate the safety and effectiveness of a new technique, two-site bimanual microincisional cataract surgery combined with viscocanalostomy plus deeper sclerectomy (two-site bimanual MICS-VC-DS), in patients with cataract and glaucoma.


METHODS
Noncomparative, interventional case series.


METHODS
From December 2005 to October 2007, a consecutive series of 12 patients (12 eyes) with uncontrolled primary open angle glaucoma (POAG) and cataract have undergone two-site bimanual MICS-VC-DS. Postoperative evaluation included visual acuity (VA), intraocular pressure (IOP), average retinal nerve fiber layer (RNFL) thickness measurement, and gonioscopic, biomicroscopic, and funduscopic examination. Paired-samples t test was used. A p value of <0.05 was taken as significant.


RESULTS
The mean duration of follow-up was 14.6 months (SD 5.8). At 9 months, mean IOP was 17.0 (SD 4), the mean IOP reduction was 13.2 mmHg (SD 5.86). At 9 months post-surgery, the complete success rate was 75%. Qualified success was achieved in 100% of patients. At 9 months, the mean number of antiglaucoma medications was 0.58 (SD 1.24) (p<0.05). Visual acuity improved by a mean value of 2.8 lines. Average RNFL thickness did not change significantly during the follow-up period (p=0.781).


CONCLUSIONS
Two-site bimanual MICS-VC-DS appears to be an effective and safe procedure with quick visual rehabilitation, acceptable mid-term IOP control, and the advantage of having fewer complications.
Baykara
Mehmet
M
Department of Ophthalmology, Uludag University School of Medicine, Bursa, Turkey. mehmetbaykara@hotmail.com
Timucin
Ozgur
O
D000959:Antihypertensive Agents / Q000008:administration & dosage; D002386:Cataract / Q000150:complications / Q000503:physiopathology / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D005902:Glaucoma, Open-Angle / Q000150:complications / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D006820:Hyaluronic Acid / Q000008:administration & dosage; D007429:Intraocular Pressure / Q000502:physiology; D019654:Lens Implantation, Intraocular; D008297:Male; D008866:Microsurgery / Q000379:methods*; D008875:Middle Aged; D018918:Phacoemulsification / Q000379:methods*; D012590:Sclera / Q000601:surgery*; D012599:Sclerostomy / Q000379:methods*; D013524:Surgical Flaps; D016896:Treatment Outcome; D055675:Viscosupplements / Q000008:administration & dosage*; D014786:Vision Disorders / Q000534:rehabilitation; D014792:Visual Acuity / Q000502:physiology
D000959:Antihypertensive Agents; D055675:Viscosupplements; D006820:Hyaluronic Acid