Purpose: To assess the efficacy and postoperative complications of
viscocanalostomy versus trabeculectomy.
Methods: Fourty eyes of fourty patients with medically uncontrolled
open-angle glaucoma were randomized either to the viscocanalostomy or to the
trabeculectomy group of the trial. Viscocanalostomy was performed according to
Stegmann`s technique using high molecular weight sodium hyaluronate to fill the
ostia of Schlemms canal. For trabeculectomy a modified Cairns-trabeculectomy
was performed. Examinations were performed before surgery and postoperatively
daily for one week. Follow-up visits were applied 1,6 and 12 months after
surgery.
Results: The mean preoperative intraocular pressure (IOP) was 26.7 (SD
6.3) mmHg for all patients enrolled. The mean postoperative IOP was 10.5 (SD
6.60) for the trabeculectomy group and 17.1 (SD 7.0) for the viscocanalostomy
group, respectively. The postoperative IOP-difference between the two groups
was statistically significant (p = 0.007). The success rate, defined as an IOP
lower than 21 mmHg without medication, was 60 % in the trabeculectomy group and
15 % in the viscocanalostomy group at 12 months postoperatively (p = 0.004).
The number of postoperative complications was lower in the viscocanalostomy
group.
Conclusions: In eyes with open angle glaucoma, viscocanalostomy, is less
effective in reducing postoperative IOP than the standard filtering procedure.
However, the risk profile, appears to be more favorable in the eyes treated
with viscocanalostomy.