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The real world efficacy and effectiveness of viscocanalostomies and phaco-viscocanalostomies in the treatment of patients with glaucoma: 5 year outcome data

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First Author: A.Ansari UK

Co Author(s):    A. Chiu   A. El Salloukh   D. Mathews              

Abstract Details

Purpose:

We aimed to evaluate the long-term outcomes of Viscocanalostomy (VC) and Phacoviscocanalostomy (PV) in controlling patients with primary and secondary glaucoma

Setting:

600 eyes treated at the Stanley Eye Unit, Abergele, North Wales were included. This included all patients requiring surgical intervention for uncontrolled raised intraocular pressures. Follow up data was retrieved for up to 5-years. Surgery was completed by a single consultant ophthalmic surgeon well versed in non-penetrating glaucoma surgery

Methods:

This non-randomised, retrospective study was conducted through patient note follow up evaluation. All patients who had either viscocanalostomy (VC) or combined phacoemulsification and viscocanalostomy (PV) over a five-year period. Intraocular pressures (IOP), number of additional anti-glaucoma medications needed, gonio-puncture rates and complications were recorded. Paired T-Test was used to compare preoperative and post-operative IOP at specified time points.

Results:

600 eyes were included (VC n=183, PV n=417). Mean age was 75.72 (9.70 SD). 30.51% of patients had previous operations with a mean cup-to-disc ratio pre-op of 0.782 (8.78). Baseline IOP was noted to be 22.89mmHg (5.54) in the total population (TP) (PV= 22.36, VC=24.10). At 72 months this was noted to be TP=14.45, PV=14.36 and VC=14.65. At 5 years 88% of patients met success criteria of controlled intraocular pressure +/- drops. 51% of patients required no additional medical therapy. 214 patients required gonio-puncture. Subset analysis was completed evaluating variances in type of procedures and well-defined success rates.

Conclusions:

VC and PV provide good long-term IOP reduction in patients with glaucoma. PV achieved a higher success rate without medication. The low complication profile with reduced post-operative care means these procedures may be a preferred option for early surgical intervention.

Financial Disclosure:

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