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Clinical Results of Isolated and Combined with Phaco-emulsification Viscocanalostomy
Ruokonen P., Lechner S., Rückert A., Tetz M.,
Humboldt-Universität zu Berlin, Charité Campus Virchow-Klinikum, Augenklinik (Berlin)
Background: For clinical evaluation of viscocanalostomy, we present an additional analysis regarding to the individual situation at starting point, frequency of complications and revisions, and differences in combination with phakoemulsification.
Patients and methods: 73 eyes of 66 patients (middle age 74 ± 14 years) received viscocanalostomy. Out of these, 20 patients underwent combined viscocanalostomy with phacoemulsification and PC-IOL implantation. Following types of glaucoma underwent surgery: PCOAG (41%), pseudoexfoliative glaucoma (44%), others (15%). Prior to glaucoma surgery patients already received IOP-lowering operations in 52% of the cases (lasertrabeculoplasty in 26%, cyclophoto- or cyclocryocoagulation in 10%, and goniotrepanation or trabeculectomy in 16%. Over 30% of the eyes had more than one glaucoma operation in history.
Results: The mean postoperative intraocular pressure reduction was 42% (from 27,9 ± 6,8 mm Hg to 16,2 ± 3,4 mm Hg). Furthermore, antiglaucomatous therapy was reduced from 2,3 ± 1,0 to 1,0 ± 1,2 (each p<0,0005). In 84% of the cases no extraordinary occurences were noted postoperatively. In 20 cases, a revision at the initial operation site had to be performed. Only once a revision necessary in the group of combined operations. Glaucoma operation in history did not influence postoperative IOP, amount of medication or rate of complication, but a revision was necessary more often (both p<0,05).
Conclusions: Dispite of difficult prerequisions a significant decrease of IOP accompanied with a reduction of antiglaucomatous medication could be found with our patients. A difference between isolated and combined operations according to number of revisions and amount of complications could be shown. With glaucoma operation in history, the number of revisions is increased.