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Combined viscocanalostomy, cataract procedure lowered IOP without bleb formation
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Viscocanalostomy combined with cataract surgery lowered IOP without formation of a bleb, a group of Japanese researchers found. An intrascleral “lake” was detected in two-thirds of patients at 1 year postop using ultrasound biomicroscopy.
Masami Park, MD, PhD, and colleagues assessed anatomic changes at the sclerectomy site after combined viscocanalostomy and cataract surgery in patients with primary open-angle glaucoma or ocular hypertension and cataract. The researchers performed ultrasound biomicroscopy (UBM) of the sclerectomy site in 84 eyes at 3, 6 and 12 months after the combined surgery. The area, radial longitudinal length and height of the intrascleral space and the meridional length of the window were measured. IOP levels, the number of glaucoma medications and bleb formation were also measured at intervals up to 12 months.
The researchers found that IOP decreased from a mean of 19.8 mm Hg preoperatively to 15.5 mm Hg 12 months postoperatively (P < .0001). Blebs were seen in two eyes (2.4%) at 1 month and in one eye (1.2%) at 3 months. The IOP decrease from preoperative levels was 5.8 mm Hg at 3 months, 4.8 mm Hg at 6 months and 4.3 mm Hg at 12 months.
The area, length and height of the intrascleral lake, as measured by UBM, all decreased significantly between months 3 and 12 postop, the authors said. Meridional length of the window was the only UBM parameter not statistically different between months 3 and 12. The lake was still present in 66.7% of cases at 12 months.
The study is published in the December issue of Journal of Glaucoma.