Viscocanalostomy

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Etsuo Chihara - One of the best experts on this subject based on the ideXlab platform.

  • phaco Viscocanalostomy versus phaco trabeculotomy a middle term study
    Journal of Glaucoma, 2006
    Co-Authors: Masami Park, Masaki Tanito, Ken Hayashi, Hirokazu Takahashi, Etsuo Chihara
    Abstract:

    PURPOSE: To compare the surgical outcomes between phaco-Viscocanalostomy and phaco-trabeculotomy in open-angle glaucoma. PATIENTS AND METHODS: In a nonrandomized, retrospective clinical study, 110 eyes underwent phaco-Viscocanalostomy (VCS group), and 110 eyes underwent phaco-trabeculotomy (LOT group). The mean follow-up was 857+/-409 (+/-SD) days (P=0.4777). RESULTS: The mean preoperative treated intraocular pressure (IOP) values were 20.2+/-3.5 mm Hg in the VCS group and 20.9+/-3.5 mm Hg in the LOT group (P=0.3377). The postoperative IOPs in the VCS group were 15.0+/-3.0 and 16.1+/-3.0 mm Hg at 1 and 3 years, and in the LOT group 16.3+/-2.9 mm Hg (P=0.0088) and 16.5+/-3.3 mm Hg (P=0.4993), respectively. The number of medications used in the VCS group was significantly lower than in the LOT group during the observation periods (P or =2 mm) and IOP spikes (> or =30 mm Hg) occurred significantly less in the VCS group (2.7 and 3.6%, respectively) than in the LOT group (26.4 and 28.2%, respectively; P<0.0001). In 13 eyes (11.8%) of the LOT group, the highest IOP level was recorded 40 mm Hg or higher. Vitreous hemorrhage and central visual loss occurred in 1 case each in the LOT group. CONCLUSIONS: After a middle-term observation, phaco-Viscocanalostomy provides better IOP control and a lower incidence of vision-threatening complications than phaco-trabeculotomy.

  • Phaco-Viscocanalostomy versus phaco-trabeculotomy: a middle-term study.
    Journal of Glaucoma, 2006
    Co-Authors: Masami Park, Masaki Tanito, Ken Hayashi, Hirokazu Takahashi, Etsuo Chihara
    Abstract:

    PURPOSE To compare the surgical outcomes between phaco-Viscocanalostomy and phaco-trabeculotomy in open-angle glaucoma. PATIENTS AND METHODS In a nonrandomized, retrospective clinical study, 110 eyes underwent phaco-Viscocanalostomy (VCS group), and 110 eyes underwent phaco-trabeculotomy (LOT group). The mean follow-up was 857+/-409 (+/-SD) days (P=0.4777). RESULTS The mean preoperative treated intraocular pressure (IOP) values were 20.2+/-3.5 mm Hg in the VCS group and 20.9+/-3.5 mm Hg in the LOT group (P=0.3377). The postoperative IOPs in the VCS group were 15.0+/-3.0 and 16.1+/-3.0 mm Hg at 1 and 3 years, and in the LOT group 16.3+/-2.9 mm Hg (P=0.0088) and 16.5+/-3.3 mm Hg (P=0.4993), respectively. The number of medications used in the VCS group was significantly lower than in the LOT group during the observation periods (P or =2 mm) and IOP spikes (> or =30 mm Hg) occurred significantly less in the VCS group (2.7 and 3.6%, respectively) than in the LOT group (26.4 and 28.2%, respectively; P

  • Comparison of surgical outcomes of combined Viscocanalostomy and cataract surgery with combined trabeculotomy and cataract surgery.
    American Journal of Ophthalmology, 2002
    Co-Authors: Masaki Tanito, Masami Park, Maki Nishikawa, Akihiro Ohira, Etsuo Chihara
    Abstract:

    Abstract PURPOSE: To compare the outcomes of combined Viscocanalostomy, phacoemulsification, and intraocular lens (IOL) implantation with combined trabeculotomy, phacoemulsification, and IOL implantation in patients with primary open-angle glaucoma (POAG). DESIGN: Nonrandomized clinical trial. METHODS: Fifty-seven eyes (57 POAG patients) that underwent Viscocanalostomy, phacoemulsification, and intraocular lens (IOL) implantation between March 2000 and April 2001 and were followed for over 6 months postoperatively comprised the Viscocanalostomy (VCS) group. Fifty-seven of 105 eyes (105 POAG patients) that underwent trabeculotomy, phacoemulsification, and IOL implantation between April 1995 and February 2000 and were followed for over 6 months and RESULTS: Significant reductions of IOP and antiglaucoma medication use occurred in both groups up to 1 year postoperatively, but were not significantly different between the two groups. The success probabilities of the VCS group for IOP control under 21, 17, and 15 mm Hg were 95%, 74%, and 44%, respectively, at 6 months, 95%, 67%, and 32% at 1 year, and not significantly different from the LOT group. All eyes in the VCS group had VA equal to or better than baseline 3 months postoperatively. The incidences of postoperative fibrin reaction (14 eyes, 25%) and microperforations of the Descemet membrane (14 eyes, 25%) in the VCS group were higher than in the LOT group ( P = .0004 and P CONCLUSIONS: Intraocular pressure reduction and VA improvement after the two procedures were similar in Japanese patients with POAG and cataract.

  • comparison of surgical outcomes of combined Viscocanalostomy and cataract surgery with combined trabeculotomy and cataract surgery
    American Journal of Ophthalmology, 2002
    Co-Authors: Masaki Tanito, Masami Park, Maki Nishikawa, Akihiro Ohira, Etsuo Chihara
    Abstract:

    PURPOSE: To compare the outcomes of combined Viscocanalostomy, phacoemulsification, and intraocular lens (IOL) implantation with combined trabeculotomy, phacoemulsification, and IOL implantation in patients with primary open-angle glaucoma (POAG). DESIGN: Nonrandomized clinical trial. METHODS: Fifty-seven eyes (57 POAG patients) that underwent Viscocanalostomy, phacoemulsification, and intraocular lens (IOL) implantation between March 2000 and April 2001 and were followed for over 6 months postoperatively comprised the Viscocanalostomy (VCS) group. Fifty-seven of 105 eyes (105 POAG patients) that underwent trabeculotomy, phacoemulsification, and IOL implantation between April 1995 and February 2000 and were followed for over 6 months and < 2 years comprised the trabeculotomy (LOT) group. The reductions of postoperative intraocular pressure (IOP) and antiglaucoma medication use in both groups were compared. Best-corrected visual acuity (VA) and complication rates were secondary outcomes. The success probabilities related to postoperative IOP level in both groups were evaluated by Kaplan-Meier life-table analysis with log-rank test. RESULTS: Significant reductions of IOP and antiglaucoma medication use occurred in both groups up to 1 year postoperatively, but were not significantly different between the two groups. The success probabilities of the VCS group for IOP control under 21, 17, and 15 mm Hg were 95%, 74%, and 44%, respectively, at 6 months, 95%, 67%, and 32% at 1 year, and not significantly different from the LOT group. All eyes in the VCS group had VA equal to or better than baseline 3 months postoperatively. The incidences of postoperative fibrin reaction (14 eyes, 25%) and microperforations of the Descemet membrane (14 eyes, 25%) in the VCS group were higher than in the LOT group (P =.0004 and P <.0001, respectively). CONCLUSIONS: Intraocular pressure reduction and VA improvement after the two procedures were similar in Japanese patients with POAG and cataract.

  • Outcome of combined phacoemulsification, intraocular lens implantation and Viscocanalostomy
    Japanese Journal of Ophthalmology, 2002
    Co-Authors: Masami Park, Masaki Tanito, Etsuo Chihara
    Abstract:

    PURPOSE To assess the pressure-lowering effect, visual acuity, and intra- and postoperative complications of combined cataract surgery, intraocular lens(IOL) implantation and Viscocanalostomy. METHODS Combined Viscocanalostomy, phacoemulsification, and IOL implantation was performed on 45 eyes, which were followed for more than 6 months after surgery. The average preoperative intraocular pressure(IOP) was 20.2 +/- 3.1(mean +/- standard deviation) mmHg, and the average medication number was 1.7. A prospective study of these cases was performed. RESULTS IOP was significantly reduced after surgery, being 13.6 mmHg at 3 months and 15.1 mmHg at 6 months postoperatively. The visual acuity was improved more than 2 lines in 38 eyes. Disruption of Descemet's membrane was noted in 5 eyes and microperforation in 9 eyes as intraoperative complications. Postoperative complications were not vision threatening and included short term hyphema in 34 eyes, fibrin deposition in 5 eyes and IOP spike(> 5 mmHg) in 5 eyes. There were no cases of hypotony, choroidal detachment, or endophthalmitis. CONCLUSION Combined Viscocanalostomy, cataract extraction, and IOL implantation was a safe and efficacious way to reduce IOP.

J Miles - One of the best experts on this subject based on the ideXlab platform.

Ziad F Bashshur - One of the best experts on this subject based on the ideXlab platform.

  • Viscocanalostomy versus trabeculotomy ab externo in primary congenital glaucoma 1 year follow up of a prospective controlled pilot study
    British Journal of Ophthalmology, 2006
    Co-Authors: Baha’ N. Noureddin, C P Elhaibi, A Cheikha, Ziad F Bashshur
    Abstract:

    Aim: To study the effectiveness of Viscocanalostomy in patients with primary congenital glaucoma of the isolated trabecular dysgenesis category and compare it with trabeculotomy ab externo. Methods: Eight patients with bilateral primary congenital glaucoma were enrolled in the study. After establishing the diagnosis, the more severely affected eye was randomly selected to undergo either trabeculotomy ab externo or Viscocanalostomy, whereas the second eye underwent the other surgery 2 weeks after the first. The patients were examined on day 1, week 1, week 4 and thereafter every 4 weeks. Intraocular pressure (IOP) and corneal diameter measurements were obtained at week 1, month 6 and at the last reported follow-up. The paired-sample’s Student’s t test was applied for statistical analysis. Results: The mean (standard deviation (SD)) follow-up period was 12.5 (1.86) months. Preoperative IOP of eyes undergoing trabeculotomy (34.0 (2.6) mm Hg) and that of eyes undergoing Viscocanalostomy (32.3 (4.1) mm Hg) showed no significant difference (p>0.1). A drop in IOP was noted in both groups at week 1, month 6 and at the last follow-up visit (p Conclusion: Viscocanalostomy proved to be as effective as trabeculotomy ab externo in lowering IOP. Moreover, it is likely to be a good surgical alternative with a higher long-term success rate in eyes with more aggressive disease.

Günter K. Krieglstein - One of the best experts on this subject based on the ideXlab platform.

  • Late hypotony as a complication of Viscocanalostomy: a case report.
    Journal of Glaucoma, 2004
    Co-Authors: Bella Gavrilova, Walter Konen, Sigrid Roters, Bert F Engels, Günter K. Krieglstein
    Abstract:

    BACKGROUND We report a long-term hypotony syndrome after deep sclerectomy, associated with intermittent rise in intraocular pressure (IOP) due to steroid response. PATIENT PRESENTATION A 55-year-old woman with high myopia (RE -9.25, LE -10.50) suffering from uncontrolled pigment open-angle glaucoma, despite laser trabeculoplasty and a cyclodestructive procedure, underwent an uneventful Viscocanalostomy. FOLLOW-UP Intraocular pressure was between 9 and 17 mm Hg with local steroid medication 5 times a day, but became unstable with steroid reduction to 3 times a day and the patient developed hypotonous IOP (3-5 mm Hg) in the fourth postoperative month. With intensification of local steroid therapy, IOP rose to 49 mm Hg, and a reduction in medication was followed by hypotony. The instability of IOP with steroid medication could not be controlled and the IOP response due to steroids diminished with time; a long-term hypotony syndrome with maculopathy developed. Surgical inspection 10 months later with repeated preparation of the scleral flap showed (like ultrasound biomicroscope examination) a normal status after Viscocanalostomy, without signs of leakage. CONCLUSIONS Late hypotony syndrome should be considered as a potential complication of Viscocanalostomy, perhaps especially in cases of myopia and former cyclodestructive procedures. In our case, despite nonpenetrating glaucoma surgery, the steroid response at first observed indicated additional outflow via the trabecular meshwork. After some months it could not be provoked any longer, leaving us to consider whether a gradual change in the trabecular meshwork hinders steroid medication changing aqueous outflow facility.

  • a prospective randomized trial of Viscocanalostomy versus trabeculectomy in open angle glaucoma a 1 year follow up study
    Journal of Glaucoma, 2002
    Co-Authors: Christoph Lüke, Thomas S. Dietlein, Philipp C Jacobi, Walter Konen, Günter K. Krieglstein
    Abstract:

    PURPOSE To assess the intraocular pressure-lowering efficacy and the postoperative complication profile of Viscocanalostomy versus trabeculectomy. PATIENTS AND METHODS Sixty eyes of 60 patients with medically uncontrolled open-angle glaucoma were randomized either to the Viscocanalostomy or to the trabeculectomy group of the trial. Viscocanalostomy was performed according to Stegmann's technique using high-molecular-weight sodium hyaluronate to fill the ostia of the Schlemm canal. For trabeculectomy, a modified Cairns-trabeculectomy was performed. Examinations were performed before surgery and postoperatively daily for 1 week. Follow-up visits were scheduled 1, 6, and 12 months after surgery. RESULTS The mean (SD) preoperative intraocular pressure was 27.1 (7.1) mm Hg for all patients enrolled. One day after surgery, mean (SD) intraocular pressure was 15.9 (5.2) for the trabeculectomy group (P <0.001) and 15.7 (3.6) for the Viscocanalostomy group (P <0.001), respectively. The success rate, defined as an intraocular pressure lower than 22 mm Hg without medication, was 56.7% in the trabeculectomy group and 30% in the Viscocanalostomy group at 12 months postoperatively (P = 0.041). The number of postoperative complications was lower in the Viscocanalostomy group than in the trabeculectomy group. CONCLUSIONS In eyes with open-angle glaucoma, Viscocanalostomy is less effective in reducing intraocular pressure than standard filtering surgery. However, postoperative complications are more frequent after filtering surgery.

  • A prospective randomized trial of Viscocanalostomy versus trabeculectomy in open-angle glaucoma: a 1-year follow-up study.
    Journal of Glaucoma, 2002
    Co-Authors: Christoph Lüke, Thomas S. Dietlein, Philipp C Jacobi, Walter Konen, Günter K. Krieglstein
    Abstract:

    PURPOSE To assess the intraocular pressure-lowering efficacy and the postoperative complication profile of Viscocanalostomy versus trabeculectomy. PATIENTS AND METHODS Sixty eyes of 60 patients with medically uncontrolled open-angle glaucoma were randomized either to the Viscocanalostomy or to the trabeculectomy group of the trial. Viscocanalostomy was performed according to Stegmann's technique using high-molecular-weight sodium hyaluronate to fill the ostia of the Schlemm canal. For trabeculectomy, a modified Cairns-trabeculectomy was performed. Examinations were performed before surgery and postoperatively daily for 1 week. Follow-up visits were scheduled 1, 6, and 12 months after surgery. RESULTS The mean (SD) preoperative intraocular pressure was 27.1 (7.1) mm Hg for all patients enrolled. One day after surgery, mean (SD) intraocular pressure was 15.9 (5.2) for the trabeculectomy group (P

  • Does the dissection depth and thickness of the deep scleral flap affect intraocular pressure after Viscocanalostomy? A clinico-pathologic correlation
    Klinische Monatsblatter Fur Augenheilkunde, 2001
    Co-Authors: Thomas S. Dietlein, Christoph Lüke, Philipp C Jacobi, Walter Konen, Günter K. Krieglstein
    Abstract:

    BACKGROUND: Non-perforating glaucoma surgery preserves the integrity of the trabecular meshwork in order to avoid postoperative hypotony. The purpose of our study was to investigate whether the morphologic variability of the excised deep scleral flap influences the postoperative intraocular pressure (IOP) after Viscocanalostomy. METHODS: Light-microscopy of the deep scleral flap was performed in 17 patients who had undergone viscocanalstomy. Morphologic parameters (thickness and dissection level of the deep scleral flap) were correlated with the postoperative IOP. RESULTS: The mean thickness of the deep scleral flap was 309 +/- 95 microns; the dissection level was too deep in 5 cases (trabecular tissue excised) and too high in 6 cases (no signs of Schlemm's canal). The max. preop. IOP was 36.2 +/- 8.5 mmHg and came down to 10.6 +/- 5.7 mmHg at day 1 postop. and 12.4 +/- 4.9 mmHg at day 3/4 postop. At a median follow-up of 6 months IOP was 21.7 +/- 5.5 mmHg. A significant correlation between postop. IOP and the morphology of the deep scleral flap could not be demonstrated. CONCLUSIONS: Variations of the thickness and depth of the deep scleral flap showed little influence on the initial IOP level following Viscocanalostomy. Other factors, f.e. the suturing of the external flap or invisible microruptures of the trabecular meshwork, could be of importance for the early postoperative IOP.

  • Primary Viscocanalostomy versus trabeculectomy in white patients with open-angle glaucoma: A randomized clinical trial.
    Ophthalmology, 2001
    Co-Authors: Christian P. Jonescu-cuypers, Philipp C Jacobi, Walter Konen, Günter K. Krieglstein
    Abstract:

    Abstract Purpose To compare Viscocanalostomy, a nonpenetrating procedure for glaucoma treatment, with trabeculectomy. Design Randomized controlled trial. Participants Twenty white subjects (20 eyes) with open-angle glaucoma with no history of surgery were enrolled. Methods Ten subjects were randomly assigned to Viscocanalostomy according to Stegmann's technique and 10 subjects to a modified Cairns trabeculectomy. A complete ophthalmologic examination was performed the day before surgery and postoperatively. Further visits were scheduled monthly for 6 to 8 months after surgery. Main outcome measures Success was defined as intraocular pressure (IOP) between 7 and 20 mmHg, with no medication. Results After a mean follow-up of 6 months (range, 6–8 months), success was obtained in 5 of 10 cases in the trabeculectomy group and in no case in the Viscocanalostomy group. With Kaplan-Meier's method, subjects with Viscocanalostomy showed shorter postoperative IOP-reduction periods than subjects undergoing trabeculectomy. Conclusions According to the results of this short-term study, trabeculectomy was more effective than Viscocanalostomy in lowering IOP in glaucomatous eyes of white patients.

Christoph Lüke - One of the best experts on this subject based on the ideXlab platform.

  • A prospective randomised trial of Viscocanalostomy with and without implantation of a reticulated hyaluronic acid implant (SKGEL) in open angle glaucoma
    British Journal of Ophthalmology, 2003
    Co-Authors: Christoph Lüke, Thomas S. Dietlein, Philipp C Jacobi, W Konen, G. K. Krieglstein
    Abstract:

    Aim: To prospectively assess the efficacy and complications of Viscocanalostomy with a reticulated hyaluronic acid implant (VSRHAI) versus standard Viscocanalostomy in patients with medically uncontrolled open angle glaucoma. Methods: A consecutive series of 40 patients (40 eyes) with uncontrolled open angle glaucoma underwent non-penetrating antiglaucomatous surgery. After the excision of the deep scleral flap they were randomly assigned to either a standard Viscocanalostomy or additional implantation of a reticulated hyaluronic acid implant. Follow up visits were over a period of 12 months after surgery. Results: The mean preoperative intraocular pressure (IOP) was 26.5 (SD 6.1) mm Hg for all patients enrolled. The mean IOP was 8.1 (SD 5.6) mm Hg 1 day after surgery for the Viscocanalostomy group (p

  • a prospective randomised trial of Viscocanalostomy with and without implantation of a reticulated hyaluronic acid implant skgel in open angle glaucoma
    British Journal of Ophthalmology, 2003
    Co-Authors: Christoph Lüke, Thomas S. Dietlein, Philipp C Jacobi, W Konen, G. K. Krieglstein
    Abstract:

    Aim: To prospectively assess the efficacy and complications of Viscocanalostomy with a reticulated hyaluronic acid implant (VSRHAI) versus standard Viscocanalostomy in patients with medically uncontrolled open angle glaucoma. Methods: A consecutive series of 40 patients (40 eyes) with uncontrolled open angle glaucoma underwent non-penetrating antiglaucomatous surgery. After the excision of the deep scleral flap they were randomly assigned to either a standard Viscocanalostomy or additional implantation of a reticulated hyaluronic acid implant. Follow up visits were over a period of 12 months after surgery. Results: The mean preoperative intraocular pressure (IOP) was 26.5 (SD 6.1) mm Hg for all patients enrolled. The mean IOP was 8.1 (SD 5.6) mm Hg 1 day after surgery for the Viscocanalostomy group (p<0.001) and 12.0 (SD 5.2) mm Hg for the VSRHAI group (p<0.001). The postoperative IOP difference between the two groups was statistically significant (p = 0.03). The success rate, defined as an IOP lower than 22 mm Hg without medication, was 40% in both groups at 12 months postoperatively (p = 0.90). The number of postoperative complications was equally low for both groups. Conclusions: Both surgical procedures, Viscocanalostomy and VSRHAI, provide comparable success rates over a 1 year follow up period. The specific intraoperative and postoperative complications of non-penetrating surgery were seen in our series, although the overall rate of postoperative complications proved equally low for both techniques.

  • Ultrasound biomicroscopy and its value in predicting the long term outcome of Viscocanalostomy.
    British Journal of Ophthalmology, 2002
    Co-Authors: Sigrid Roters, Christoph Lüke, Philipp C Jacobi, W Konen, Christian P. Jonescu-cuypers, Bert F Engels, G. K. Krieglstein
    Abstract:

    Several investigators have shown renewed interest in surgical reduction of intraocular pressure (IOP) by non-perforating glaucoma surgery. Non-perforating glaucoma surgery avoids opening the anterior chamber and decompressing the eye, thus circumventing many serious complications associated with standard trabeculectomy.1 In open angle glaucoma, the endothelium of Schlemm`s canal and the immediately adjacent trabecular meshwork show increased resistance to aqueous outflow,2 resulting in increased IOP. Recently, a new technique of non-penetrating glaucoma surgery, Viscocanalostomy, has been described; it results in better outflow in open angle glaucoma.3,4 In this procedure Schlemm’s canal is unroofed and Descemet’s membrane is separated 1–2 mm from the corneoscleral junction, resulting in a thinner but intact window to the anterior chamber, through which aqueous humour diffuses into a subscleral lake created by the removal of an inner scleral flap. Filtration is improved when the diameter of Schlemm’s canal is enlarged by the injection of a high viscosity viscoelastic material into the opened ostia of the canal. The nature of the outflow pathways that lead to the lowering of IOP in Viscocanalostomy surgery is controversial.5,6 Several mechanisms may be involved: these include permanent subconjunctival filtration (as in trabeculectomy), aqueous flow into the canalicular system that reaches the venous circulation or the uveoscleral space, with or without an intrascleral “lake,” and drainage from Schlemm’s canal to capillaries and veins within the intrascleral canals and subconjunctival tissue. Morphological studies have shown varying dissection depths of the deep scleral flap that often leads to an unroofing of Schlemm’s canal.7,8 Postsurgical examination with the high resolution ultrasound biomicroscope (UBM), developed by Pavlin and Foster,9 allows imaging of the trabeculo-descemetic membrane, the intrascleral hypoechoic cavity and subconjunctival filtration (clinically not visible during slit lamp examination) with a resolution of 50 μm.10–12 UBM examination can also detect the presence of small amount of fluid, such as subchoroidal effusion, between layers of the eye.13 The aim of the present study was to analyse the aqueous drainage pathways under the scleral flap and to examine the presence and dimensions of the subconjunctival and suprachoroidal space in eyes that underwent Viscocanalostomy. In this study UBM findings were used to evaluate potential predictive parameters with reference to long term success or failure of Viscocanalostomy.

  • a prospective randomized trial of Viscocanalostomy versus trabeculectomy in open angle glaucoma a 1 year follow up study
    Journal of Glaucoma, 2002
    Co-Authors: Christoph Lüke, Thomas S. Dietlein, Philipp C Jacobi, Walter Konen, Günter K. Krieglstein
    Abstract:

    PURPOSE To assess the intraocular pressure-lowering efficacy and the postoperative complication profile of Viscocanalostomy versus trabeculectomy. PATIENTS AND METHODS Sixty eyes of 60 patients with medically uncontrolled open-angle glaucoma were randomized either to the Viscocanalostomy or to the trabeculectomy group of the trial. Viscocanalostomy was performed according to Stegmann's technique using high-molecular-weight sodium hyaluronate to fill the ostia of the Schlemm canal. For trabeculectomy, a modified Cairns-trabeculectomy was performed. Examinations were performed before surgery and postoperatively daily for 1 week. Follow-up visits were scheduled 1, 6, and 12 months after surgery. RESULTS The mean (SD) preoperative intraocular pressure was 27.1 (7.1) mm Hg for all patients enrolled. One day after surgery, mean (SD) intraocular pressure was 15.9 (5.2) for the trabeculectomy group (P <0.001) and 15.7 (3.6) for the Viscocanalostomy group (P <0.001), respectively. The success rate, defined as an intraocular pressure lower than 22 mm Hg without medication, was 56.7% in the trabeculectomy group and 30% in the Viscocanalostomy group at 12 months postoperatively (P = 0.041). The number of postoperative complications was lower in the Viscocanalostomy group than in the trabeculectomy group. CONCLUSIONS In eyes with open-angle glaucoma, Viscocanalostomy is less effective in reducing intraocular pressure than standard filtering surgery. However, postoperative complications are more frequent after filtering surgery.

  • A prospective randomized trial of Viscocanalostomy versus trabeculectomy in open-angle glaucoma: a 1-year follow-up study.
    Journal of Glaucoma, 2002
    Co-Authors: Christoph Lüke, Thomas S. Dietlein, Philipp C Jacobi, Walter Konen, Günter K. Krieglstein
    Abstract:

    PURPOSE To assess the intraocular pressure-lowering efficacy and the postoperative complication profile of Viscocanalostomy versus trabeculectomy. PATIENTS AND METHODS Sixty eyes of 60 patients with medically uncontrolled open-angle glaucoma were randomized either to the Viscocanalostomy or to the trabeculectomy group of the trial. Viscocanalostomy was performed according to Stegmann's technique using high-molecular-weight sodium hyaluronate to fill the ostia of the Schlemm canal. For trabeculectomy, a modified Cairns-trabeculectomy was performed. Examinations were performed before surgery and postoperatively daily for 1 week. Follow-up visits were scheduled 1, 6, and 12 months after surgery. RESULTS The mean (SD) preoperative intraocular pressure was 27.1 (7.1) mm Hg for all patients enrolled. One day after surgery, mean (SD) intraocular pressure was 15.9 (5.2) for the trabeculectomy group (P

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