Abstract
Purpose :
To compare outcomes of combine procedures: phaco-canaloplasty (PC) versus phaco- nonpenetrating deep sclerectomy (PNDS) with HealaFlow.
Methods :
A randomized, prospective study. The study included eyes after PC (37 eyes) and PNDS (38 eyes). The indication for surgery was uncontrolled primary open angle glaucoma (POAG) and cataract. Best corrected visual acuity (BCVA), intraocular pressure (IOP), anterior and posterior segments of the eye, number of medications were examined. Follow-up examinations were done on days 1 and 7 and at 1, 3, 6, 12,18,24 months. Quality of life was estimated with NEI- 25 questionnaire. For statistical analyses Mann-Whitney U test,Friedman ANOVA, Student’s t-test, analysis of variance were used;
Results :
Mean IOP decreased significantly in both groups at 24 month follow-up. Preoperative mean IOP in PC was 19,4±5,9mmHg and in PNDS 19,7±5,4mmHg, there were no significant differences in IOP (p>0,05). Starting from 6 month till the end of observation IOP for PC was statistically lower (p<0.05) At 24 month mean IOP in PC was 13,81±3,2mmHg and 15,14±2,90mmHg in PNDS. Pre-op BCVA for PC was 0,40±0,43 logMAR and PNDS 0,30±0,32 logMAR. It improved in both groups at 24 months and mean BCVA was respectively 0,05±,12logMAR and 0,12±0,23 logMAR. Throughout the study no differences in BCVA were observed but for 24 month follow-up, which revealed better results for PC (p<0,05). The number of antiglaucoma medications significantly decreased in both groups, in PC from 2,59±0,86 to 0,53±0,86 and in PNDS from 2,81±0,98 to 1,11±1,24 (p<0,05). The most frequent early postoperative complication in PC was hyphema, which was observed in 58% of subjects and in PNDS bleb fibrosis (30%). In PNDS postoperative care additional procedures where used, such as suturelysis, 5-FU subconjunctival injection, needling and goniopuncture. No differences were found in QoL.
Conclusions :
Both PC and PNDS lead to effective decrease in the IOP in mid-term observation , however PC achieves statistically better IOP results starting from 6 month.
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.