The efficacy of Viscocanalostomies and combined phacoemulsification with Viscocanalostomies in the treatment of patients with glaucoma: a non-randomised observational study
| العنوان: | The efficacy of Viscocanalostomies and combined phacoemulsification with Viscocanalostomies in the treatment of patients with glaucoma: a non-randomised observational study |
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| المؤلفون: | Bhavani Karri, Divya Mathews, Andrew Want, Derek Kwun-hong Ho |
| المصدر: | BMC Ophthalmology, Vol 18, Iss 1, Pp 1-8 (2018) BMC Ophthalmology |
| بيانات النشر: | Springer Science and Business Media LLC, 2018. |
| سنة النشر: | 2018 |
| مصطلحات موضوعية: | Adult, Male, medicine.medical_specialty, Intraocular pressure, Non-Randomized Controlled Trials as Topic, genetic structures, medicine.medical_treatment, Perforation (oil well), Glaucoma, Subgroup analysis, Viscoelastic Substances, Young Adult, 03 medical and health sciences, 0302 clinical medicine, lcsh:Ophthalmology, Glaucoma surgery, Humans, Medicine, Descemet Membrane, Antihypertensive Agents, Intraocular Pressure, Aged, Retrospective Studies, Aged, 80 and over, Phacoemulsification, business.industry, Retrospective cohort study, General Medicine, Middle Aged, medicine.disease, eye diseases, Surgery, Ophthalmology, lcsh:RE1-994, 030221 ophthalmology & optometry, Female, business, Complication, 030217 neurology & neurosurgery, Research Article |
| الوصف: | Background To evaluate the outcomes of Viscocanalostomy (VC) and Phacoviscocanalostomy (PV) in controlling primary and secondary glaucoma in a large cohort of patients from a single eye unit and performed by a single surgeon. Methods This non-randomised, retrospective study was conducted on 620 eyes of 458 patients. All patients who had either viscocanalostomy (VC) or combined phacoemulsification and viscocanalostomy (PV) over a three-year period were included. Intraocular pressures (IOP), number of anti-glaucoma medications used, and any complications were recorded over a 3-year follow up period. Paired T-Test was used to compare preoperative and post-operative IOP at specified time points. Kaplan–Meier survival models were used to determine success rates over the study period. Results Six hundred twenty procedures were performed during the 3-year study period, of which 427 were PV and 193 VC. The mean follow-up was 31.8 months. Overall complete success (IOP ≤ 21 mmHg, without medication) at 3 years was achieved in 65.7% of patients, with qualified success (IOP ≤21 mmHg with or without medication) achieved in 96.0%. Subgroup analysis showed complete success rate of 76.0% for PV and 63.1% for VC (p = 0.005), with qualified success 95.9% for PV and 94.0% for VC (p = 0.668). Mean pre-operative IOP (mmHg) for all procedures was 23.02 ± 5.6, with PV and VC subgroups at 22.54 ± 5.10 and 24.06 ± 6.45. Post-operatively IOP at month 12 and 36 was 14.74 ± 3.57 and 14.40 ± 3.17 respectively for all procedures, 14.62 ± 3.26 and 14.44 ± 3.10 for PV, and 15.03 ± 4.18 and 14.31 ± 3.33 for VC. Across all procedures, pre-operatively an average of 3.05 ± 0.96 anti-glaucoma medications were used. This reduced to 0.13 ± 0.39 in 12 months and 0.38 + 0.71 by 36 months. Sixty-five cases had complications due to trabeculo-Descemet window perforation during viscocanalostomy with 7 cases developing complications from the cataract element. In the 12.9% of patients who had complications there were no differences of IOP noted at 3 years. Conclusion VC and PV have good IOP lowering capacity and are both effective at sustaining a reduction in IOP at 3 years. PV achieved a higher success rate without medication. The low complication profile with reduced post-operative care means these procedures may be a preferred option for early surgical intervention. |
| تدمد: | 1471-2415 |
| DOI: | 10.1186/s12886-018-0773-7 |
| URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::9a5b2b6e8290bbb06e4a088ef7a494da https://doi.org/10.1186/s12886-018-0773-7 |
| Rights: | OPEN |
| رقم الانضمام: | edsair.doi.dedup.....9a5b2b6e8290bbb06e4a088ef7a494da |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 14712415 |
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| DOI: | 10.1186/s12886-018-0773-7 |