Reult of vicocanalotomy for primary open-angle glaucoma

PURPOE: Vicocanalotomy i a nonperforating filtering urgical procedure that may avoid potoperative complication common with tandard trabeculectomy. Thi tudy wa conducted to determine the urgical outcome of thi procedure after a potoperative obervation period of 12 to 36 month. METHOD: Interventional conecutive cae erie. In a propective tudy, a conecutive erie of 67 eye of 67 patient with chronic primary open-angle glaucoma underwent VC. Excluded were patient with angle cloure glaucoma, pot-traumatic, uveitic, neovacular, or dygenetic glaucoma, a well a patient who needed combined cataract-glaucoma procedure. The patient were examined potoperatively on the firt day, firt week, at 1 month, and then at 3-month interval through 36 month. At each viit, bet-corrected viual acuity, intraocular preure (IOP), and the appearance of the urgical wound, anterior chamber, and indirect funducopy were recorded. REULT: Complete ucce wa defined a IOP le than or equal to 20 mm Hg and greater than or equal to 30% IOP reduction without medical or additional urgical treatment compared with the IOP from a preoperative level with maximum tolerated medical therapy; qualified ucce IOP le than or equal to 20 mm Hg with treatment or an IOP reduction le than 30% from preoperative level with maximum tolerated medical therapy; and qualified failure of an IOP greater than 20 mm Hg with glaucoma medication, but no optic nerve or viual field deterioration and complete failure a an eye requiring further glaucoma urgery or lot viual function. The overall ucce rate wa 88% at 1 year, 90% at 2 year, and 88% at 3 year, with a complete ucce of 68% at 1 year, 60% at 2 and 59% at 3 year. Four eye had a perforation of the Decemet membrane, three of thoe needed peripheral iridectomy; ix eye had a microperforation not needing a peripheral iridectomy. Five eye preented hyphema. Eight eye preented deterioration of viual function after urgery: three eye becaue of corneal atigmatim, one eye becaue of cataract, and four preented glaucomatou deterioration of the viual field depite preure under 20 mm Hg. Four eye had progreive cataract formation judged a independent from urgery. CONCLUION: VC provide an overall ucce rate of 88% and a complete ucce of 59% 3 year after urgery. The major immediate complication i perforation of the Decemet membrane with a need for peripheral iridectomy. No eriou long-term complication were noted in our mall erie. Viual function remained table in 55 eye (82%).