Monday, February 28, 2011

Phacoviscocanalostomy for open-angle glaucoma with concomitant age-related cataract

Phacoviscocanalostomy controls IOP in eyes with pseudoexfoliation glaucoma, POAG

Phacoviscocanalostomy controlled IOP and improved visual acuity in eyes with pseudoexfoliation glaucoma and primary open-angle glaucoma, a study found.

The prospective study included 30 eyes that underwent phacoviscocanalostomy for cataract and pseudoexfoliation glaucoma and 30 eyes that underwent the procedure for cataract and uncontrolled primary open-angle glaucoma (POAG). Mean age was 70.7 years in the pseudoexfoliation glaucoma group and 58.6 years in the POAG group; the difference was statistically significant (P = .001).

Mean follow-up was 19.7 months. Examinations were performed 1 day, 1 week, and 1, 3, 6 and 12 months after surgery.

Both groups had immediate and statistically significant decreases in mean IOP from baseline (P < .0001).

The pseudoexfoliation glaucoma group had significantly lower mean IOP than the POAG group at all follow-up points (P < .01).

Mean IOP reduction was 12.2 mm Hg (49.7%) in the pseudoexfoliation glaucoma group and 6.7 mm Hg (30.9%) in the POAG group at final follow-up.

Also at final follow-up, 25 eyes in the pseudoexfoliation glaucoma group (83.3%) and 16 eyes in the POAG group (53.3%) achieved IOP of 15 mm Hg or lower without medication; the difference was statistically significant (P < .05).

Uncorrected and corrected visual acuity improved significantly in both groups (P < .005) at all follow-up points.

The complication rate was low and did not influence surgical outcomes. No cases of shallowing of the anterior chamber, hypotony, choroidal detachment or endophthalmitis were reported.