Trabeculectomy is not the best surgical option for glaucoma

[Late results of phaco-canaloplasty in patients with concomitant advanced pseudoexfoliation glaucoma and cataract]

PURPOSE

To assess the safety and efficacy of phaco-canaloplasty in patients with concomitant advanced pseudoexfoliation glaucoma and cataract.

MATERIAL AND METHODS

The study included 56 patients (57 eyes) who underwent phacoanaloplasty guided by Glaucolight microcatheter. All patients were followed up for 48 months. Visual acuity, changes of intraocular pressure (IOP), use of glaucoma medications, incidence of complications, as well as postsurgical interventions were examined.

RESULTS

Mean preoperative IOP decreased significantly from 29.8 mmHg (15.8-61.6) with a mean of 1.92 (0-3) glaucoma drops to 12.9 mmHg (11.0-19.6) with a mean of 0.12 (0-3) drops respectively 48 months after phacocanaloplasty. Mean visual acuity increased from preoperative 0.15 (0.01-0.8) to 0.6 (0.01-1.2). The most frequent complications included intraoperative perforation of Descemet's membrane (4 eyes, 7%) and hyphema (37 eyes, 65%), IOP spikes (4 eyes, 7%) and inflammation (4 eyes, 7%) in the early postoperative period.

CONCLUSION

Phacocanaloplasty in eyes with concomitant advanced pseudoexfoliation glaucoma and cataract re-establishes the natural outflow system and leads to significant IOP reduction with minimal risk of intra- and postoperative complications.