Combined viscocanalostomy-trabeculectomy for management of advanced Glaucoma- a comparative study of the contralateral eye: a pilot study

ABSTRACT

To compare combined viscocanalostomy-trabeculectomy [VISCO-TRAB] to trabeculectomy [TRAB] for the management of advanced glaucoma. The study cohort comprised of 18 subjects with bilateral advanced glaucoma who underwent VISCO-TRAB surgery [VISCO-TRAB group] in the right eye and TRAB [TRAB group] in the left eye. VISCO-TRAB constituted lamellar scleral flap, deep scleral flap dissection with deroofing of Schlemm's canal [SC], viscodilation of SC, penetrating trabeculectomy, peripheral iridectomy, and tight flap closure. All eyes received subconjunctival mitomycin. Success criteria included intraocular pressure [IOP] < 14 mmHg or > 30% lowering of IOP with no devastating complications. A P value less than 0.05 was considered statistically significant. Mean IOP was significantly lower after VISCO-TRAB compared to TRAB at 1 week and 3 months postoperatively [P<0.05]. No eyes lost more than two lines of Snellen acuity. There were more hypotony-related complications after TRAB than VISCO-TRAB surgery. Target IOP was achieved in 83.3% in the VISCO-TRAB group compared to 55.6% in the TRAB group. Combined VISCO-TRAB is effective in reducing IOP to the target level for advanced glaucoma with lower postoperative complications