Azaripour Ebrahim, Khakpour Yaser, Soltani-Moghadam Reza, Moravvej Zahra, Medghalchi Abdolreza, Behboudi Hassan, Alizadeh Yousef, Soltanipour Soheil, Kianmehr Shila
Eye Research Center, Department of Ophthalmology, Amiralmomenin Hospital, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran.
GI Cancer Screening and Prevention Research Center, Department of Community Medicine, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran.
J Ophthalmic Vis Res. 2021 Oct 25;16(4):566-573. doi: 10.18502/jovr.v16i4.9746. eCollection 2021 Oct-Dec.
Viscocanalostomy represents an alternative to standard penetrating glaucoma surgery. The aim of this study is to compare the outcomes of combined phacoemulsification and viscocanalostomy in eyes with primary open-angle glaucoma (POAG) versus eyes with pseudoexfoliation glaucoma (PEXG).
In this prospective non-randomized comparative study, eyes with cataract and POAG or PEXG were enrolled. Pre- and postoperative data including best corrected visual acuity (BCVA), intraocular pressure (IOP), and the number of antiglaucoma medications administered were recorded at each visit. All patients underwent phacoviscocanalostomy. Complete success was defined as the IOP of 21 mmHg or less without the administration of medication while a qualified success reported the same IOP parameters either with or without the administration of medication.
Fifty-four eyes with POAG and fifty-four with PEXG underwent phacoviscocanalostomy. The mean follow-up time was 23.36 8.8 months (range, 6-40 months). The mean postoperative IOP reduced significantly in both groups, although the mean IOP reduction was significantly greater in PEXG eyes (14.7 8.9 vs 10.1 7.7 mmHg) ( = 0.05). At the final follow-up visit, the mean postoperative IOP was 14.1 2.1 and 16.6 3.5 mmHg in the PEXG and POAG eyes, respectively ( = 0.001). A complete success rate of 88.9% and 75.9% was achieved in PEXG and POAG eyes, respectively ( = 0.07). The qualified success rate was 100% in the PEXG and 85.2% in POAG groups ( = 0.03).
Phacoviscocanalostomy achieved significant IOP reduction and visual improvement in both POAG and PEXG patients. Our results indicated that in terms of IOP reduction, this procedure was more effective in treating PEXG.
粘小管切开术是标准穿透性青光眼手术的一种替代方法。本研究的目的是比较原发性开角型青光眼（POAG）患者与假性剥脱性青光眼（PEXG）患者行白内障超声乳化吸除联合粘小管切开术的效果。
在这项前瞻性非随机对照研究中，纳入患有白内障且合并POAG或PEXG的患者。每次随访时记录术前和术后的数据，包括最佳矫正视力（BCVA）、眼压（IOP）以及使用的抗青光眼药物数量。所有患者均接受了超声乳化粘小管切开术。完全成功定义为眼压≤21 mmHg且无需使用药物，而合格成功定义为无论是否使用药物，眼压达到相同参数。
54只POAG患眼和54只PEXG患眼接受了超声乳化粘小管切开术。平均随访时间为23.36±8.8个月（范围6 - 40个月）。两组术后平均眼压均显著降低，尽管PEXG患眼中平均眼压降低幅度更大（14.7±8.9 vs 10.1±7.7 mmHg）（P = 0.05）。在最后一次随访时，PEXG患眼和POAG患眼的术后平均眼压分别为14.1±2.1和16.6±3.5 mmHg（P = 0.001）。PEXG患眼和POAG患眼的完全成功率分别为88.9%和75.9%（P = 0.07）。PEXG组的合格成功率为100%，POAG组为85.2%（P = 0.03）。
超声乳化粘小管切开术在POAG和PEXG患者中均能显著降低眼压并改善视力。我们的结果表明，就降低眼压而言，该手术治疗PEXG更有效。
