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  • Title: Randomized comparison of the intraocular pressure-lowering effect of phacoviscocanalostomy and phacotrabeculectomy.
    Author: Kobayashi H, Kobayashi K.
    Journal: Ophthalmology; 2007 May; 114(5):909-14. PubMed ID: 17397924.
    Abstract:
    PURPOSE: To compare the intraocular pressure (IOP)-lowering effect of combined viscocanalostomy and phacoemulsification and combined trabeculectomy and phacoemulsification with mitomycin C in eyes with primary open-angle glaucoma. DESIGN: Prospective randomized 1-year trial. PARTICIPANTS: Forty consecutive patients (40 eyes) with primary open-angle glaucoma and cataract. INTERVENTION: Eyes were assigned randomly either to trabeculectomy with mitomycin C or to viscocanalostomy in combination with phacoemulsification and intraocular lens implantation. MAIN OUTCOME MEASURES: Success rate based on IOP. RESULTS: Mean baseline IOP was 24.0+/-2.0 mmHg in the viscocanalostomy group and 23.7+/-2.6 mmHg in the trabeculectomy group (P = 0.7). Mean postoperative IOP was 13.7+/-2.2 mmHg at 3 months, 14.8+/-3.3 mmHg at 6 months, and 14.9+/-3.0 mmHg at 12 months in the viscocanalostomy group and 12.1+/-4.0 mmHg at 3 months, 13.8+/-4.7 mmHg at 6 months, and 14.1+/-4.4 mmHg at 12 months in the trabeculectomy group. There was no significant difference in the mean IOP between the groups at any time. At 12 months, 17 patients (85%) in the viscocanalostomy group and 16 patients (80%) in the trabeculectomy group achieved an IOP of 20 mmHg or less without medication (P = 0.7). Complications included 2 cases (10%) of flat/shallow anterior chamber and 4 cases (20%) of hypotony in the trabeculectomy group, whereas intraoperative microperforation of Descemet's membrane occurred in 3 cases (15%) in the viscocanalostomy group. CONCLUSIONS: There was no significant difference in IOP reduction between viscocanalostomy and trabeculectomy with mitomycin C in combination with phacoemulsification and intraocular lens implantation in patients with primary open-angle glaucoma.
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