Clinical outcomes of phacoviscoviscocanalostomy with and without mitomycin-C in primary open angle glaucoma and cataract
Ebrahim Azaripour Masoule1 *
- eye research center,department of eye,amiralmomenin hospital,school of medicine,guilan university of medical sciences,rasht,iran
Abstract: Glaucoma is one of the most important causes of blindness in the worldwide. Vision loss due to glaucoma is irreversible, although it can be prevented with early diagnosis and treatment. Treatment options for glaucoma include medical therapy, laser and surgical procedures. Anti-glaucoma medication causes a significant reduction in intraocular pressures (IOP) but does not sustain low intraocular pressure (IOP) in the long-term. On the other hand, surgical therapy offers better control of IOP particularly in non-compliant patients.
Methods: This non randomized, prospective comparative study included 158 eyes of 158 patients with primary open angle glaucoma (POAG) and cataract. Phacoviscocanalostomy with mitomycin –C was performed in 84 eyes with POAG and cataract and phacoviscocanalostomy without mitomycin-C was performed in 74 eyes with POAG and cataract. Preoperative and postoperative intraocular pressures (IOP), number of antiglaucoma medication, intraoperative and postoperative complications were recorded throughout the follow-up period
Results: The mean follow-up after surgery was 20.13±7.9 months. Mean IOP decreased significantly 1 month after surgery in both groups (p < 0.001) and remained significantly lower from its preoperative value at all follow-up visits. The postoperative mean IOP at the last follow up in phacoviscocanalostomy with and without mitomycin-C was 14.98±4.8 mmHg and 16.84±5.0 mmHg, respectively (p=0.001). Complete success rate in phacoviscocanalostomy with and without mitomycin groups was 83.1% and 66.8%, respectively (p =0.008). Qualified success rate was achieved in 89.4% eyes in the phacoviscocanalostomy with mitomycin group and 83.8% of phacoviscocanalostomy without mitomycin-C group (p=0.534). The Best corrected visual acuity (BCVA) in both group improved significantly post-operatively (p =0.001). Postoperative antiglaucoma medication in both groups were significantly less than the preoperative values (p=0.001).
Conclusion: Phacoviscocanalostomy with and without mitomycin-C are effective procedures in the control of IOP in patients with POAG and cataract. Higher complete success rates was achieved in phacoviscocanalostomy with mitomycin-C. Therefore, phacoviscocanalostomy with mitomycin-c are recommended in eyes with medically uncontrolled (POAG) and coexisting cataract.
