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Viscocanalostomy-cataract procedure lowers IOP better than standard cataract surgery in study

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Patients who underwent a combined viscocanalostomy-cataract procedure achieved greater IOP reductions than those who underwent standard cataract surgery, according to a study.

Takuhei Shoji, MD, and colleagues at the Sensho-kai Eye Institute compared the midterm safety and efficacy of phacoviscocanalostomy — a combined viscocanalostomy, phacoemulsification and IOL implantation procedure — with standard cataract surgery in patients with normal-tension glaucoma (NTG) and cataract. A total of 31 eyes underwent phacoviscocanalostomy, while 35 eyes underwent standard cataract surgery, according to the study.

At 36 months' follow-up, mean IOP in the phacoviscocanalostomy group was 14.1 ± 1.6 mm Hg, down from 17.2 ± 1.5 mm Hg at baseline. In the cataract surgery group, mean postop IOP was 15.6 ± 3.4 mm Hg, down from 16.7 ± 1.4 mm Hg at baseline. The difference in IOP improvement was statistically significant between the groups at all follow-up points (P < .05), the authors said.

At 24 months' follow-up, patients in the phacoviscocanalostomy group who were taking glaucoma medications had 78.5% chance of achieving a 20% reduction in IOP and a 35.5% of achieving a 30% reduction. At 48 months' follow-up, the probabilities fell to 58% and 28%, respectively.

For patients in the phacoviscocanalostomy group who were not taking medications, the probabilities were 67.4% and 37.4%, respectively, at 24 months and 44.2% and 26.6%, respectively, at 48 months. Patients in the phacoviscocanalostomy group had significantly better probabilities than the cataract surgery group (P < .001), the authors said.

"The current study found that phacoviscocanalostomy maintains lower IOP, lessens the need for glaucoma medication postoperatively, successfully maintains the visual field and does not negatively affect postoperative visual acuity in patients with combined cataract and NTG compared with cataract surgery only, after which there was also a slight, but significant, reduction in IOP postoperatively," the authors said.

The study is published in the July issue of the Journal of Cataract & Refractive Surgery.