Primary viscocanalostomy versus trabeculectomy for primary open-angle glaucoma

Yalvaç, Ilgaz Saĝdiç; Şahin, Mehmet Oğuz; Ekşioğlu, Ümit; Midillioğlu, Inci Koçak; Aslan, Bekir Sıtkı; Duman, Sunay

doi:10.1016/j.jcrs.2004.02.073

Cited by 100 publications

(51 citation statements)

References 23 publications

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“…A total of 24 articles were excluded, including 9 full reports [16,17,18,19,20,21,22,23,24], and 15 meeting abstracts (see Appendix 1). Out of them, 17 randomized controlled trials were included in the present meta-analysis, 14 published in full form [25,26,27,28,29,30,31,32,33,34,35,36,37,38] and 3 published in abstract form (see Appendix 2). The flowchart of the studies included in our analysis is shown in figure 1.…”

Section: Resultsmentioning

confidence: 99%

Efficacy and Tolerability of Nonpenetrating Filtering Surgery in the Treatment of Open-Angle Glaucoma: A Meta-Analysis

Cheng

Wei

et al. 2009

Ophthalmologica

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Aims:To evaluate the efficacy and tolerability of nonpenetrating filtering surgery in the treatment of patients with open-angle glaucoma. Methods: Pertinent studies were selected by extensive searches. A total of 17 randomized controlled trials were included in the present meta-analysis. The main outcome measures were risk differences (RDs) of complete success for efficacy and postoperative complications for tolerability. Pooled estimates were computed according to a random-effects model. Results:Viscocanalostomy and deep sclerectomy were significantly less effective than tra- beculectomy, and pooled RDs of complete success were –0.16 (95% confidence interval, CI, –0.30 to –0.02) and –0.10 (–0.19 to 0.00). Deep sclerectomy plus mitomycin C (MMC) was also less effective than trabeculectomy plus MMC, with pooled RD of complete success being –0.16 (95% CI –0.32 to –0.01). Viscocanalostomy and deep sclerectomy caused main complications in fewer patients than trabeculectomy. Conclusions:Viscocanalostomy and deep sclerectomy were less effective than trabeculectomy in the treatment of open-angle glaucoma, and deep sclerectomy plus MMC was also less effective than trabeculectomy plus MMC. However, viscocanalostomy and deep sclerectomy were associated with fewer complications than trabeculectomy.

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Section: Resultsmentioning

confidence: 99%

Efficacy and Tolerability of Nonpenetrating Filtering Surgery in the Treatment of Open-Angle Glaucoma: A Meta-Analysis

Cheng

Wei

et al. 2009

Ophthalmologica

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“…3 Kaplan-Meier plot of the cumulative probability of failure for group 1 (CP or canaloplasty only with successful suture placement) and group 2 (PhacoCP or combined cataract-canaloplasty eyes with successful suture placement). Failure was defined as an IOP> 18 mmHg on two consecutive visits efficacy results are comparable to the lowest IOPs achieved in non-penetrating glaucoma surgery including viscocanalostomy [13][14][15], deep sclerectomy with various implants [16,17], and deep sclerectomy with adjunctive mitomycin C [18,19]. There is some rationale to believe that the addition of circumferential viscodilation and the trabecular meshwork tensioning suture in canaloplasty may provide an additional IOP lowering effect compared to the creation of a scleral lake and a Descemet's window alone, as is often achieved with deep sclerectomy or viscocanalostomy.…”

Section: Discussionmentioning

confidence: 99%

Three-year canaloplasty outcomes for the treatment of open-angle glaucoma: European study results

Bull¹,

Wolff²,

Körber

et al. 2011

Graefes Arch Clin Exp Ophthalmol

108

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“…26,27,29 If no such additional procedures were performed, the mean IOP was correspondingly higher (upto 17.8 mm Hg). 9,30,31 Although we acknowledge that subconjunctival filtration is one of the methods of drainage, 5-fluorouracil injection is helpful to control wound healing, and laser goniopuncture increases aqueous outflow, the diversity of surgical modifications and postoperative manipulations makes direct comparison of efficacy difficult. From a pathophysiological perspective, the term 'non-penetrating' glaucoma surgery is imprecise and should be reconsidered.…”

Section: Discussionmentioning

confidence: 99%

“…Direct comparison to trabeculectomy yielded a lower incidence of postoperative complications, 7,8 but IOP reduction was found to be less effective. 9,10 Viscocanalostomy is able to open just 1201 of SC, limiting its effectiveness and enhancing the procedure's likelihood of failure; as far as our experience goes, re-collapse of SC and the closure of the ostia of the collector channels are the main causes for failure in viscocanalostomy. Enlarging a greater part may increase the chance for a more consistent patency of SC and a circumferential flow.…”

Section: Introductionmentioning

confidence: 99%

Comparing two tensioning suture sizes for 360° viscocanalostomy (canaloplasty): a randomised controlled trial

Grieshaber

Pienaar

Olivier

et al. 2010

Eye

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Purpose To compare the safety and efficacy of two polypropylene (Prolene) sutures for tensioning of the inner wall of Schlemm's canal (SC) in black African patients with primary open-angle glaucoma (POAG) undergoing canaloplasty. Methods In a prospective randomised trial of 90 patients, canaloplasty was performed with a flexible microcatheter (iTrack-250A) and sodium hyaluronidate 1.4% (Healon GV). After complete circumferential dilatation of the SC, a Prolene suture, either 6-0 Prolene (group 1) or 10-0 Prolene (group 2), was retracted through the SC and tightened leaving tension on the canal and trabecular meshwork. Nd:YAG laser goniopuncture was not performed postoperatively. Results The mean preoperative intraocular pressure (IOP) was 42.7 mm Hg±12.5 (SD) in group 1 and 45.0 mm Hg ± 12.1 (SD) in group 2 (P ¼ 0.70). The mean postoperative IOP without medications was 18.4 mm Hg ± 7.1 (SD) in group 1 and 16.4 mm Hg ± 6.6 (SD) in group 2 at 1 month (P ¼ 0.10), 19.2 mm Hg±6.4 (SD) in group 1 and 16.4 mm Hg±4.9 (SD) at 15 months (P ¼ 0.04). Pressures equal or less than 21, 18, and 16 mm Hg without medications (complete success) at 12 months were 51.0% (95% confidence interval (CI) 0.35-0.73), 34.1% (95% CI 0.21-0.56), and 21.2% (95% CI 0.11-0.42) in group 1, and 76.9% (95% CI 0.62-0.96), 68.8% (95% CI 0.54-0.89), and 53.6% (95% CI 0.38-0.76) in group 2, respectively. In the Cox regression analysis, IOP o18 mm Hg without medications depended significantly on the type of Prolene (hazard ratio (HR) 2.60, 95% CI 1.24-5.46, P ¼ 0.01) and age (HR 1.3, 95% CI 1.03-1.86, P ¼ 0.03), but not on preoperative IOP (HR 1.01, 95% CI 0.99-1.04, P ¼ 0.16) and gender (HR 0.67, 95% CI 0.34-1.33, P ¼ 0.26). No filtering bleb was observed. Intra-and postoperative complications were similarly rare in the two groups and included partial 'cheese-wiring' (2), Descemet's rupture (2), and hyphaema (3). Conclusions In this clinical trial, IOP reduction was substantial in canaloplasty and slightly greater in combination with 10-0 Prolene than 6-0 Prolene sutures at an equally low complication rate. Younger age, but not the level of IOP at surgery, had a positive effect on the amount of IOP reduction, thus suggesting that an early surgical intervention to re-establish physiological outflow offers the best prognosis.

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Primary viscocanalostomy versus trabeculectomy for primary open-angle glaucoma

Abstract: Primary trabeculectomy lowered IOP more than viscocanalostomy in POAG patients. However, the complication rate was lower in the viscocanalostomy group.

Cited by 100 publications

References 23 publications

Efficacy and Tolerability of Nonpenetrating Filtering Surgery in the Treatment of Open-Angle Glaucoma: A Meta-Analysis

Efficacy and Tolerability of Nonpenetrating Filtering Surgery in the Treatment of Open-Angle Glaucoma: A Meta-Analysis

Three-year canaloplasty outcomes for the treatment of open-angle glaucoma: European study results

Comparing two tensioning suture sizes for 360° viscocanalostomy (canaloplasty): a randomised controlled trial

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