Five year results of viscocanalostomy

Abstract

Aim: To prospectively study the success rate and complications of viscocanalostomy, a non-penetrating glaucoma surgery. Methods: Prospective non-randomised consecutive case series of 57 eyes (57 patients) with medically uncontrolled primary and secondary open angle glaucoma. Viscocanalostomy was performed on all participants with injection of viscoelastic in the surgically created ostia of Schlemm's canal as well as in the scleral bed, the superficial scleral flap was loosely sutured. Intraocular pressure, visual acuity, and number of goniopunctures were measured. Results: The mean follow up period was 34.1 months. The mean preoperative intraocular pressure (IOP) was 24.6 mm Hg; while the mean postoperative IOP was 5.6 mm Hg at day 1 and 13.9 mm Hg at 36 month. Patients who achieved IOP below 21 mm Hg with or without medication were 90% at 60 months, complete success rate (IOP<21 mm Hg without medication) was 60% at 60 months. 21 patients (37%) needed Nd:YAG goniopuncture postoperatively to control raised IOP, mean time for goniopuncture application was 9.4 months, mean pre-goniopuncture IOP was 20.4 mm Hg and mean postgoniopuncture IOP was 12.6 mm Hg (p <0.0001).Conclusion: Viscocanalostomy appears to be a promising modification of filtering surgery.

Viscocanalostomy versus trabeculectomy for primary open angle glaucoma: 4-year prospective randomized clinical trial

“…Although intra-operative complications were very low in both groups, we do appreciate that the surgeon had more experience in trabeculectomy surgery and that this may have influenced long-term outcomes. Other studies have quoted goniopuncture rates between 13 and 37% post viscocanalostomy 6,7 which is appreciably higher than in our group of patients where only one patient required We defined success following the procedure as an IOP of below 18 mm Hg without treatment. Many previous glaucoma studies have used 21 mm Hg as a cutoff for defining complete success.…”

Hyaluronsäuregele zur Druckregulierung in der Glaukomtherapie

“…B. als viskoelastischer Körper-oder Weichgewebeersatz, als Trägermaterial für Arzneimittelfreisetzung, als Füllstoff für Gewebe, als Haut-und Gewebeschutz oder zur Gewebetrennung verwendet [14,23]. Auch in der Glaukombehandlung kommt die HA bereits bei chirurgischen Eingriffen zum Einsatz [11,28].…”

Non-penetrating intracanalicular partial trabeculectomy via the ostia of Schlemm's canal

“…The relatively low rate of intraoperative as well as of postoperative complications represents the main advantage of this type of glaucoma surgery. NPGS has been proven to be a safer technique than other available types of glaucoma surgery including trabeculectomy [11,47,50,66,67].…”

“…The main claimed disadvantages of NPGS include a limited hypotensive effect [19,43], which sometimes requires postoperative laser goniopuncture [49,67], and the relative complexity of the NPGS technique for a surgeon with its long learning curve comparing to trabeculectomy [66].…”