Efficacy Of Viscocanalostomy Research Articles

Viscocanalostomy in patients with glaucoma secondary to uveitis: Preliminary report

The authors performed a prospective, single-center clinical trial to assess the efficacy of viscocanalostomy in eyes with uncontrolled glaucoma secondary to uveitis. Eleven eyes of 11 patients with a mean age of 52.2 years ± 19.9 (SD) and inadequate intraocular pressure (IOP) control (IOP > 21 mm Hg) under maximum-tolerated medical therapy had viscocanalostomy. There was a significant reduction in IOP from a mean baseline value of 35.1 ± 7.0 mg Hg (range, 23 to 48 mm Hg) to a mean final value of 18.1 ± 4.9 mm Hg (range 12 to 30 mm Hg) ( P P = .0004). There were no significant postoperative complications. The conclusion was that viscocanalostomy is a safe, effective alternative for treating intractable glaucoma in patients with uveitis. —Michael D. Wagoner

Comparison of outcomes of viscocanalostomy and phacoviscocanalostomy

Background: Many adults who undergo glaucoma filtering surgery also need surgical treatment of coexisting cataract. Recent reports of the use of new alternative nonpenetrating techniques in combination with phacoemulsification have given encouraging results. The purpose of this study was to compare the safety and efficacy of viscocanalostomy and phacoviscocanalostomy in the management of medically uncontrolled open-angle glaucoma.Methods: Twenty patients who underwent phacoviscocanalostomy in one eye each were enrolled in the study. Twenty matching patients who underwent viscocanalostomy in one eye each at our institution were selected as the control group. Postoperative reductions in intraocular pressure (10P) and number of antiglaucoma medications were compared between the groups. Visual acuity and complications were secondary outcomes.Results: Significant reductions of IOP and of use of antiglaucoma medication occurred in both groups (p < 0.05) these results were comparable in the two groups (p>0.05). The mean IOP reduction was 34% in the eyes that underwent viscocanalostomy alone and 38% in the eyes that underwent phacoviscocanalostomy. The success rates of the two procedures were also comparable (p>0.05). In the combined-surgery group the best-corrected visual acuity improved by 2 or more lines in 18 eyes (90%). Intraoperative complications did not occur in either group.Interpretation: Combining phacoemulsification with viscocanalostomy did not have a negative effect on the 10P control achieved by viscocanalostomy alone and did not increase the complication rate. Phacoviscocanalostomy was safe and effective in the surgical management of eyes with both glaucoma and cataract.

Viscocanalostomy and phacoviscocanalostomy: long-term results

Purpose: To determine the safety and efficacy of viscocanalostomy and cataract extraction by phacoemulsification combined with viscocanalostomy (phacoviscocanalostomy) in the management of medically uncontrolled glaucoma.Setting: Department of Ophthalmic Surgery, Warrington Hospital, Warrington, England.Methods: This prospective nonrandomized study comprised 101 consecutive eyes of 73 patients with medically uncontrolled glaucoma having viscocanalostomy or phacoviscocanalostomy. Outcomes measured were intraocular pressure (IOP) control, visual acuity, gonioscopy, bleb morphology, and complications associated with surgery. Examinations were performed preoperatively and 1 and 7 days and 1, 3, 6, 9, and 12 months postoperatively and then at 6-month intervals. The mean follow-up was 23.9 months ± 11 (SD) (range 6 months to 3.5 years).Results: The mean preoperative IOP was 24.9 ± 5.7 mm Hg on 2.27 ± 0.8 medications and the mean postoperative IOP at last follow-up, 16.14 ± 2.9 mm Hg on 0.1 medications. A postoperative IOP of 21 mm Hg or less was achieved in 93% of eyes. In the remaining 7%, an addition of a mean of 1.4 medications achieved an IOP less than 21 mm Hg. No case required further glaucoma surgery. The mean percentage of IOP reduction in eyes having viscocanalostomy alone was 37% and in eyes having phacoviscocanalostomy, 33%. Complications were minor and included 4 small hyphemas, 5 small choroidal detachments, 1 iris prolapse through the phaco incision, and 10 intraoperative microperforations of the trabeculo-Descemet’s window. Transient postoperative pressure elevations secondary to topical steroids occurred in 18% of eyes.Conclusions: Viscocanalostomy and phacoviscocanalostomy were safe and effective in the surgical management of glaucoma and combined glaucoma and cataract. There was a low incidence of complications postoperatively and throughout the long-term follow-up.