Phaco-viscocanalostomy versus Phaco-trabeculotomy

Park, Masami; Hayashi, Ken; Takahashi, Hirokazu; Tanito, Masaki; Chihara, Etsuo

doi:10.1097/01.ijg.0000212265.96864.77

Cited by 24 publications

(32 citation statements)

References 26 publications

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“…These findings are well-documented in the literature when comparing nonpenetrating approaches with classic trabeculectomy, and could be related to the absence of iris manipulation and iridectomy in non-perforating surgery [20,21].…”

Section: Discussionmentioning

confidence: 70%

Comparison between phaco-deep sclerectomy and phaco-deep sclerectomy reconverted into phaco-trabeculectomy: series of fellow eyes

Cabarga-Nozal¹,

Arnalich‐Montiel²,

Fernández-Buenaga³

et al. 2010

Graefes Arch Clin Exp Ophthalmol

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Section: Discussionmentioning

confidence: 70%

Comparison between phaco-deep sclerectomy and phaco-deep sclerectomy reconverted into phaco-trabeculectomy: series of fellow eyes

Cabarga-Nozal¹,

Arnalich‐Montiel²,

Fernández-Buenaga³

et al. 2010

Graefes Arch Clin Exp Ophthalmol

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“…Trabeculotomy is likely compatible with glaucoma medications even after surgery [31]. In addition, we performed sinusotomy following trabeculotomy [30,31]. The early postoperative increases in IOPs were lower and less frequent in the cases treated with both trabeculotomy and sinusotomy.…”

Section: Introductionmentioning

confidence: 96%

“…XFG is reported as a good indication for trabeculotomy, as well as for developmental glaucoma and steroid-induced glaucoma [27][28][29]; it is unlike trabeculectomy, as trabeculotomy is not associated with special postoperative care and various bleb-related complications. Trabeculotomy is likely compatible with glaucoma medications even after surgery [31]. In addition, we performed sinusotomy following trabeculotomy [30,31].…”

Section: Introductionmentioning

confidence: 99%

“…MMC trabeculectomy is one type of glaucoma filtering surgery that requires the formation and maintenance of a filtering route and proper bleb for long-standing efficacy [22][23][24][25]. Another surgical option for XFG is trabeculotomy [26][27][28][29][30][31]. XFG is reported as a good indication for trabeculotomy, as well as for developmental glaucoma and steroid-induced glaucoma [27][28][29]; it is unlike trabeculectomy, as trabeculotomy is not associated with special postoperative care and various bleb-related complications.…”

Section: Introductionmentioning

confidence: 99%

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Trabeculotomy combined with phacoemulsification, intraocular lens implantation and sinusotomy for exfoliation glaucoma

et al. 2011

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“…A retrospective study 17 has compared phaco-viscocanalostomy with phaco-trabeculectomy. At three years, phaco-viscocanalostomy showed a higher success rate (IOP <21 mmHg with no medication) than phaco-trabeculectomy, 58.2 versus 36.0 %, and a lower incidence of vision-threatening complications.…”

Section: Mechanism Of Actionmentioning

confidence: 99%

Comparing Viscocanalostomy with Trabeculectomy

Carassa¹

2011

US Ophthalmic Review

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In recent years, non-penetrating glaucoma surgery has been seen as a safer alternative to trabeculectomy. This class of procedures is mainly represented by 'deep sclerectomy', 'viscocanalostomy,' and 'canaloplasty' (a recent and more reproducible variation of viscocanalostomy). The aim of all these procedures is to allow drainage of the aqueous humor from the anterior chamber, not through a patent scleral opening but by slow percolation through the inner trabecular meshwork and/or Descemet's membrane ('sclerodescemetic membrane'). This avoids sudden drops in intraocular pressure (IOP), hypotony, and flat chambers. The absence of anterior chamber opening and iridectomy limits the risk of cataract and infection. The advantages of viscocanalostomy and canaloplasty are that not only are they non-penetrating, like deep sclerectomy, but also, most importantly, they restore the physiologic outflow pathway, thus avoiding external filtration in the majority of eyes. This makes the success of the procedure partly independent of conjunctival or episcleral scarring, a leading cause of failure in trabeculectomy, with fewer indications for wound healing modulation. Moreover, the absence of an elevated filtering bleb avoids related ocular discomfort, and the procedures can be carried out in any quadrant. Operative TechniqueViscocanalostomy is a demanding surgical technique that requires a long learning curve. As soon as the window is completed, the inner scleral flap is excised.The next step is the sealing of the lake, which is obtained by tightly suturing the outer scleral flap with seven 10-0 nylon stitches.High-molecular-weight sodium hyaluronate is then injected underneath the flap to fill the intrascleral space temporarily, preventing it from collapsing and scarring in the early post-operative period. Finally, the conjunctiva is sutured in place. Mechanism of ActionViscocanalostomy increases the aqueous outflow through different paths. Injection of viscoelastic into the canal not only dilates the canal and associated collectors but also disrupts the internal and external walls of Schlemm's canal and adjacent trabecular layers, thus increasing the trabecular outflow facility and making the procedure act as a 'micro-trabeculotomy' (see Figure 5).

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Phaco-viscocanalostomy versus Phaco-trabeculotomy

Abstract: After a middle-term observation, phaco-viscocanalostomy provides better IOP control and a lower incidence of vision-threatening complications than phaco-trabeculotomy.

Cited by 24 publications

References 26 publications

Comparison between phaco-deep sclerectomy and phaco-deep sclerectomy reconverted into phaco-trabeculectomy: series of fellow eyes

Comparison between phaco-deep sclerectomy and phaco-deep sclerectomy reconverted into phaco-trabeculectomy: series of fellow eyes

Trabeculotomy combined with phacoemulsification, intraocular lens implantation and sinusotomy for exfoliation glaucoma

Comparing Viscocanalostomy with Trabeculectomy

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