Phacoviscocanalostomy for open-angle glaucoma with concomitant age-related cataract

Alexandros N Stangos¹, Anestis Mavropoulos², Gordana Sunaric-Megevand^1,3

¹Division of Ophthalmology, Department of Clinical Neurosciences, University Hospitals of Geneva, Geneva, Switzerland; ²Division of Bone Diseases, Department of Rehabilitation and Geriatrics, University Hospitals of Geneva, Geneva, Switzerland; ³Department of Ophthalmology, Clinique Générale Beaulieu, Fondation Rothschild, Geneva, Switzerland

Purpose: To evaluate the efficacy and safety of combined viscocanalostomy and phacoemulsification (phacoviscocanalostomy) for medically uncontrolled open-angle glaucoma (OAG) with concomitant age-related cataract.

Design: Prospective, noncomparative, interventional case-series study.

Methods: Phacoviscocanalostomy was performed on 50 eyes of 50 consecutive patients with medically uncontrolled OAG and clinically significant age-related cataract. Surgical outcome was defined as an overall success by the following criteria: no visual field deterioration; no optic-neuropathy progression; postoperative intraocular pressure (IOP) ≤ 20 mmHg and IOP reduction 30% compared to baseline values with or without medication. When medications were not required, success was defined as complete. The surgical outcome and the complication rates were documented and analyzed up to 36 months postoperatively.

Results: Mean follow-up (}SD) was 29.02 } 7.09 months. Mean, baseline IOP (}SD) had significantly decreased from 23.51 } 4.48 mmHg to 14.06 } 1.64 mmHg at the last follow-up visit for each patient (p < 0.001). The overall success was 94% at 12 months, 92% at 24 months, and 82% at 36 months. The success was complete in 74% at 12 months, and in 67% at 24 months and at 36 months. No serious complications were documented.

Conclusion: Phacoviscocanalostomy can be considered an efficient and safe alternative surgical modality for medically uncontrolled OAG with concomitant age-related cataract.

Keywords: age-related cataract, non-penetrating glaucoma surgery, open-angle glaucoma, phacoemulsification, phacoviscocanalostomy, viscocanalostomy