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Outcomes of viscocanalostomy and phaco-viscocanalostomy in patients with advanced glaucoma

Tsagkataki, M, Bampouras, TM and Choudhary, A (2018) Outcomes of viscocanalostomy and phaco-viscocanalostomy in patients with advanced glaucoma. Graefe's Archive for Clinical and Experimental Ophthalmology, 256 (8). pp. 1481-1487. ISSN 0721-832X

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Open Access URL: http://.doi.org/10.1007/s00417-018-4010-0 (Published version)


Purpose: To determine the medium-term outcomes for patients with advanced glaucoma undergoing viscocanalostomy. Methods: All patients with advanced glaucoma (mean deviation (MD) − 12.00 dB or above) and patients with poor visual acuity secondary to advanced glaucoma which precluded formal visual field assessment undergoing viscocanalostomy (VC) and phaco-viscocanalostomy between 2010 and 2014 under the care of a single surgical team were included. Intraocular pressure (IOP), visual acuity (VA) and visual field outcomes were assessed from data prospectively collected into a surgical outcome database. Success was defined at two IOP cut-off points: IOP ≤ 21 and ≤ 16 mmHg with (qualified) or without (complete) medications. Results: One hundred thirty-five patients were included. Mean IOP changed from 23.6 ± 6.4 mmHg pre-operatively to 15.3, 15.8 and 14.8 mmHg at 1, 2 and 3 years, a change of 35, 33.5 and 39% respectively. Qualified success for an IOP ≤ 21 mmHg was achieved in 95.66, 90.6 and 80% and complete success in 52.5, 48.6 and 30.6% at year 1, 2 and 3. Qualified success for an IOP ≤ 16 mmHg was achieved in 66.6, 66.05 and 60% and complete success in 44.8, 37.6 and 30.6% at year 1, 2 and 3. The cumulative probability for achieving an IOP ≤ 21 mmHg with or without drops was 86.1, 81.4 and 81.4% at 12, 24 and 36 months. Eleven patients (8.1%) failed to achieve adequate IOP control and needed further surgical intervention. Eleven (8.1%) patients needed an intervention (Yag goniopuncture) following VC. Four patients (2.9%) had some post-operative complications, which resolved within 2 weeks following surgery. Nine patients (6.7%) lost more than 2 Snellen lines. There was no significant change in the MD across time points. Conclusion: Viscocanalostomy and viscocanalostomy combined with phacoemulsification is a safe and effective method of controlling IOP in the medium term in patients with advanced glaucoma.

Item Type: Article
Uncontrolled Keywords: Conjunctiva; Humans; Glaucoma; Chondroitin Sulfates; Hyaluronic Acid; Drug Combinations; Treatment Outcome; Phacoemulsification; Filtering Surgery; Retrospective Studies; Intraocular Pressure; Visual Acuity; Visual Fields; Adult; Aged; Aged, 80 and over; Middle Aged; Descemet Membrane; Female; Male; Viscoelastic Substances; Advanced glaucoma; Glaucoma; Non-penetrating glaucoma surgery; Phaco-viscocanalostomy; Viscocanalostomy; Adult; Aged; Aged, 80 and over; Chondroitin Sulfates; Conjunctiva; Descemet Membrane; Drug Combinations; Female; Filtering Surgery; Glaucoma; Humans; Hyaluronic Acid; Intraocular Pressure; Male; Middle Aged; Phacoemulsification; Retrospective Studies; Treatment Outcome; Viscoelastic Substances; Visual Acuity; Visual Fields; 1113 Opthalmology and Optometry; Ophthalmology & Optometry
Subjects: Q Science > QH Natural history > QH301 Biology
Q Science > QP Physiology
R Medicine > RC Internal medicine > RC0321 Neuroscience. Biological psychiatry. Neuropsychiatry
Divisions: Sport & Exercise Sciences
Publisher: Springer Science and Business Media LLC
SWORD Depositor: A Symplectic
Date Deposited: 06 Feb 2023 08:15
Last Modified: 06 Feb 2023 08:15
DOI or ID number: 10.1007/s00417-018-4010-0
URI: https://researchonline.ljmu.ac.uk/id/eprint/18783
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