Abstract
Abstract: :
Purpose: To compare the surgical outcomes of combined cataract surgery and viscocanalostomy (VCS) with or without nonpenetrating trabeculectomy (NPT) in 128 patients of open–angle glaucoma. Methods: In a prospective comparative, controlled study, 63 eyes underwent combined cataract surgery and VCS (NPT(–) group) and 65 eyes underwent combined cataract surgery and VCS with NPT (NPT(+) group). The postoperative IOP, the probability of successful IOP reduction without medications, visual acuity changes, and postoperative complications were compared between the two groups. Results:The mean preoperative IOP of 19.9±3.3 (S.D) mmHg in the NPT (–) group decreased significantly to 13.9±6.8 at 3 days, 14.7±3.2 at 12 months, 15.3±2.9 mmHg at 18 months. The IOP of 19.8±3.2 mmHg in the NPT(+) group decreased significantly to 11.3±5.3 at 3 days, 14.7±2.9 at 12 months, and 15.3 ±3.0 mmHg at 18 months. There was no significant difference in IOP levels between two groups ( P≥0.3779) except for the IOP level at 3 postoperative days (P= 0.00294). The probabilities of achieving IOPs under 21mmg, and 15 mmHg at 18 months in the NPT(–) groups were 74.4% and 21.0% without medications, and those in the NPT(+) group were 78.0% and 20.1% without medications. These success probabilities were not significantly different between two groups (P=0.9104 and 0.9445, respectively). The visual outcomes were similar in both groups. The incidence of IOP spike more than 30 mmHg (5 eyes, 7.9%) and fibrin formation (10 eyes, 15.9%) in the NPT(–) group were higher than in NPT(+) group ( 0%; P=0.0266, 6.2%; P=0.0944). Hyphema was observed in about half cases and bleb formation more than 1 month was rare (less than 5%) in both groups. Conclusions: The long–term reduction of the IOP was not enhanced by an addition of NPT on the VCS. However, the combination with NPT provided lower incidence of postoperative complications such as IOP spike and fibrin formation.
Keywords: clinical (human) or epidemiologic studies: outcomes/complications • clinical (human) or epidemiologic studies: treatment/prevention assessment/controlled clinical trials