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G. Sunaric Mégevand, E. Oueghlani, P. Leuenberger; Influence of the Learning Curve on the Surgical Outcome of Viscocanalostomy . Invest. Ophthalmol. Vis. Sci. 2003;44(13):1217.
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Purpose: The aim of the study is to evaluate the influence of the surgical experience in performing viscocanalostomy (VCS) on the success rate and complication rate. Methods: We compared the surgical outcome of a consecutive series of 75 eyes of 75 patients with primary open-angle glaucoma (POAG) who have undergone VCS between 1999 and 2001 with the published series* of our first 67 eyes of 67 consecutives patients with POAG operated between 1997 and 1999. The surgery was performed by the two same surgeons respecting the same procedure. Results: The mean follow-up was 21.5 months ranging from 1 year to 3 years. The overall success rate was 95 % at 1 year, 91 % at 2 years and 92 % at 3 years compared to 88% at 1 year, 90 % at 2 years and 88% at 3 years in the first series. Complete success was 79.5% at 1 year, 72.2% at 2 years and 66% 3 years compared to 68%, 60% and 59% respectively in the first series. These differences are statistically significant. Compared to the first series, less complications were observed in the second one. Two eyes had perforation of descemet membrane, one needed a peripheral iridotomy (PI). Two eyes had microperforation not needing PI. 3 eyes presented hyphema. One eye presented visual function deterioration because of cataract. Conclusions: Comparing results of our first series of 64 eyes with POAG that underwent VCS with eyes operated after 2 years of surgical experience we can observe an improvement of the success rate and decrease in the complication rate with improved surgical skills. Thus the learning curve in performing VCS is long and seems to play an important role in the surgical outcome. *Results of viscocanalostomy for primary open-angle glaucoma, G Sunaric-Megevand and P Leuenberger, American journal of ophthalmology, volume 132, issue 2 august 2001
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