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The efficacy of Viscocanalostomies and combined phacoemulsification with Viscocanalostomies in the treatment of patients with glaucoma: a non-randomised observational study.

Abstract To evaluate the outcomes of Viscocanalostomy (VC) and Phacoviscocanalostomy (PV) in controlling primary and secondary glaucoma in a large cohort of patients from a single eye unit and performed by a single surgeon.
PMID
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Authors

Mayor MeshTerms
Keywords
Journal Title bmc ophthalmology
Publication Year Start




PMID- 29720128
OWN - NLM
STAT- MEDLINE
DCOM- 20180516
LR  - 20180516
IS  - 1471-2415 (Electronic)
IS  - 1471-2415 (Linking)
VI  - 18
IP  - 1
DP  - 2018 May 2
TI  - The efficacy of Viscocanalostomies and combined phacoemulsification with
      Viscocanalostomies in the treatment of patients with glaucoma: a non-randomised
      observational study.
PG  - 111
LID - 10.1186/s12886-018-0773-7 [doi]
AB  - BACKGROUND: To evaluate the outcomes of Viscocanalostomy (VC) and
      Phacoviscocanalostomy (PV) in controlling primary and secondary glaucoma in a
      large cohort of patients from a single eye unit and performed by a single
      surgeon. METHODS: This non-randomised, retrospective study was conducted on 620
      eyes of 458 patients. All patients who had either viscocanalostomy (VC) or
      combined phacoemulsification and viscocanalostomy (PV) over a three-year period
      were included. Intraocular pressures (IOP), number of anti-glaucoma medications
      used, and any complications were recorded over a 3-year follow up period. Paired 
      T-Test was used to compare preoperative and post-operative IOP at specified time 
      points. Kaplan-Meier survival models were used to determine success rates over
      the study period. RESULTS: Six hundred twenty procedures were performed during
      the 3-year study period, of which 427 were PV and 193 VC. The mean follow-up was 
      31.8 months. Overall complete success (IOP </= 21 mmHg, without medication) at 3 
      years was achieved in 65.7% of patients, with qualified success (IOP </=21 mmHg
      with or without medication) achieved in 96.0%. Subgroup analysis showed complete 
      success rate of 76.0% for PV and 63.1% for VC (p = 0.005), with qualified success
      95.9% for PV and 94.0% for VC (p = 0.668). Mean pre-operative IOP (mmHg) for all 
      procedures was 23.02 +/- 5.6, with PV and VC subgroups at 22.54 +/- 5.10 and
      24.06 +/- 6.45. Post-operatively IOP at month 12 and 36 was 14.74 +/- 3.57 and
      14.40 +/- 3.17 respectively for all procedures, 14.62 +/- 3.26 and 14.44 +/- 3.10
      for PV, and 15.03 +/- 4.18 and 14.31 +/- 3.33 for VC. Across all procedures,
      pre-operatively an average of 3.05 +/- 0.96 anti-glaucoma medications were used. 
      This reduced to 0.13 +/- 0.39 in 12 months and 0.38 + 0.71 by 36 months.
      Sixty-five cases had complications due to trabeculo-Descemet window perforation
      during viscocanalostomy with 7 cases developing complications from the cataract
      element. In the 12.9% of patients who had complications there were no differences
      of IOP noted at 3 years. CONCLUSION: VC and PV have good IOP lowering capacity
      and are both effective at sustaining a reduction in IOP at 3 years. 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.
FAU - Want, Andrew
AU  - Want A
AD  - Stanley Eye Unit, Abergele Hospital, Llanfair Road, Abergele, Conwy, LL22 8DP,
      UK.
FAU - Ho, Derek K-H
AU  - Ho DK
AD  - Stanley Eye Unit, Abergele Hospital, Llanfair Road, Abergele, Conwy, LL22 8DP,
      UK.
FAU - Karri, Bhavani
AU  - Karri B
AD  - Stanley Eye Unit, Abergele Hospital, Llanfair Road, Abergele, Conwy, LL22 8DP,
      UK.
FAU - Mathews, Divya
AU  - Mathews D
AUID- ORCID: http://orcid.org/0000-0003-0036-8860
AD  - Stanley Eye Unit, Abergele Hospital, Llanfair Road, Abergele, Conwy, LL22 8DP,
      UK. [email protected]
LA  - eng
GR  - 16/WA/0345/WalesRec5 Bangor
PT  - Journal Article
PT  - Observational Study
DEP - 20180502
PL  - England
TA  - BMC Ophthalmol
JT  - BMC ophthalmology
JID - 100967802
RN  - 0 (Antihypertensive Agents)
RN  - 0 (Viscoelastic Substances)
SB  - IM
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Antihypertensive Agents/therapeutic use
MH  - Descemet Membrane/surgery
MH  - Female
MH  - Glaucoma/physiopathology/*surgery
MH  - Humans
MH  - Intraocular Pressure/physiology
MH  - Male
MH  - Middle Aged
MH  - Non-Randomized Controlled Trials as Topic
MH  - Phacoemulsification/*methods
MH  - Retrospective Studies
MH  - Viscoelastic Substances/*administration & dosage
MH  - Young Adult
PMC - PMC5932795
EDAT- 2018/05/04 06:00
MHDA- 2018/05/17 06:00
CRDT- 2018/05/04 06:00
PHST- 2017/10/30 00:00 [received]
PHST- 2018/04/13 00:00 [accepted]
PHST- 2018/05/04 06:00 [entrez]
PHST- 2018/05/04 06:00 [pubmed]
PHST- 2018/05/17 06:00 [medline]
AID - 10.1186/s12886-018-0773-7 [doi]
AID - 10.1186/s12886-018-0773-7 [pii]
PST - epublish
SO  - BMC Ophthalmol. 2018 May 2;18(1):111. doi: 10.1186/s12886-018-0773-7.