ABSTRACT
AIM:To evaluate the results of mitomycin-C (MMC)-augmented viscocanalostomy in patients with open-angle glaucoma.METHODS:This retrospective study included 104 patients who underwent viscocanalostomy surgery between December 2007 and March 2014.Pre-and postoperative intraocular pressure (IOP), number of glaucoma medications, visual acuity, complications, adjunctive procedure (laser goniopuncture and/or glaucoma medication), and success rate were recorded.Complete success was defined as IOP≤21 mmHg without additional medication, and qualified success was defined as IOP≤21 mmHg with or without glaucoma medication.RESULTS:Mean preoperative IOP was 27.5±9.2 mmHg and mean postoperative IOP was 14.5±6.6 mmHg at the last visit (P<0.001).Mean visual acuity before and after surgery were 0.42±0.4 and 0.32±0.4, respectively (P=0.726).Qualified success was achieved in 106 (86.9%) eyes and complete success was achieved in 62 (50.8%) eyes.Laser goniopuncture was performed in 43 (35.2%) eyes and glaucoma medication usage rate was 49.1%.The mean postoperative followup period was 27.29±16.78 (1-79)mo.CONCLUSION:Although viscocanalostomy is a safer option due to low complication rates and stable visual acuity, without laser goniopuncture(LGP), surgical success rate is still very low.Further comparative studies are necessary to evaluate the contribution of MMC to viscocanalostomy surgery.
ABSTRACT
Purpose: To compare the results of conventional 1064 nm neodymium‑doped yttrium‑aluminum garnet laser goniopuncture (Nd:YAG‑GP) and selective 532 nm Nd:YAG laser (selective laser trabeculoplasty [SLT]) gonioreconditioning (GR) on trabeculo‑Descemet’s membrane in eyes resistant to viscocanalostomy surgery. Methods: Thirty‑eight eyes of 35 patients who underwent laser procedure after successful viscocanalostomy surgery were included in the study. When postoperative intraocular pressure (IOP) was above the individual target, the eyes were scheduled for laser procedure. Nineteen eyes underwent 532 nm SLT‑GR (Group 1), and the remaining 19 eyes underwent conventional 1064 nm Nd:YAG‑GP (Group 2). IOPs before and after laser (1 week, 1 month, 3 months, 6 months, 1 year, and last visit), follow‑up periods, number of glaucoma medications, and complications were recorded for both groups. Results: Mean times from surgery to laser procedures were 17.3 ± 9.6 months in Group 1 and 13.0 ± 11.4 months in Group 2. Mean IOPs before laser procedures were 21.2 ± 1.7 mmHg in Group 1 and 22.8 ± 1.9 mmHg in Group 2 (P = 0.454). Postlaser IOP measurements of Group 1 were 12.1 ± 3.4 mmHg and 13.8 ± 1.7 mmHg in the 1st week and last visit, respectively; in Group 2, these measurements were 13.6 ± 3.7 mmHg and 14.9 ± 4.8 mmHg, respectively. There were statistically significant differences (P < 0.001) in IOP reduction at all visits in both groups; the results of the two groups were similar (P > 0.05). Mean follow‑up was 16.6 ± 6.4 months after SLT‑GR and 18.9 ± 11.2 months after Nd:YAG‑GP. Conclusions: While conventional Nd:YAG‑GP and SLT‑GR, a novel procedure, are both effective choices in eyes resistant to viscocanalostomy, there are fewer complications with SLT‑GR. SLT‑GR can be an alternative to conventional Nd:YAG‑GP.