Five-year results of viscotrabeculotomy versus conventional trabeculotomy in primary congenital glaucoma: A randomized controlled study

PURPOSE

To assess the long-term results of viscotrabeculotomy in infants with primary congenital glaucoma and to compare its outcome with conventional trabeculotomy.

PATIENTS AND METHODS

A prospective randomized comparative study included infants with primary congenital glaucoma younger than 2 years. Patients were divided into two groups: viscotrabeculotomy group and conventional trabeculotomy group. Preoperative and postoperative intraocular pressures, corneal diameter, intraoperative and postoperative complications, and success rates were compared between two groups. All the patients were followed up for 5 years.

RESULTS

The study included 154 eyes of 92 infants distributed randomly among the two groups; 78 and 76 eyes in viscotrabeculotomy and conventional trabeculotomy groups, respectively. In both groups, there was a statistically significant intraocular pressure reduction at all time points of the follow-up periods compared to the preoperative values (p < 0.0001). At 5 years, viscotrabeculotomy group showed significant reduction of the mean postoperative intraocular pressure (49.47%) than conventional trabeculotomy group (48.64%) (p < 0.0001). Intraocular pressure was statistically lower in viscotrabeculotomy starting from 12th month and till the end of the follow-up. At 5 years, the total success rate of viscotrabeculotomy group was 89.74% compared to 85.53% in conventional trabeculotomy group without significant difference (p = 0.487). The postoperative mean values of the cup/disk ratio in viscotrabeculotomy group showed statistically lower values compared to conventional trabeculotomy group (p = 0.019). Postoperative hyphema was statistically higher in conventional trabeculotomy group (p < 0.0001). All eyes that underwent a reoperation before 5 years follow-up were excluded from the statistical workup of the study after reoperation, except for calculation of success/failure.

CONCLUSION

Viscotrabeculotomy and conventional trabeculotomy proved to be effective in cases of primary congenital glaucoma. Viscotrabeculotomy appeared to have prolonged stability in controlling the intraocular pressure with higher success rates and lower complications.

Surgical Outcomes of Visco-Circumferential-Suture-Trabeculotomy Versus Rigid Probe Trabeculotomy in Primary Congenital Glaucoma: A 3-Year Randomized Controlled Study

PURPOSE

The aim was to compare the long-term surgical outcomes of visco-circumferential-suture-trabeculotomy (VCST) and rigid probe viscotrabeculotomy (VT) in patients with primary congenital glaucoma (PCG).

PATIENTS AND METHODS

The study was conducted on 84 (47 right) eyes of 49 (32 males) children PCG to the pediatric ophthalmology unit of Mansoura Ophthalmic Center of Mansoura University, Egypt between 2015 and 2018. An initial office examination was followed by an examination under general anesthesia to establish the diagnosis of PCG. The children were then scheduled for surgery and the eyes randomly assigned to VCST or VT. Follow-up visits were scheduled at the first day, first week, first, and third months and then every 3 months for 1 year.

RESULTS

The mean±SD age of the study children at presentation was 4.8±2.1 and 4.9±1.7 months in the VCST and the VT groups, respectively (P=0.827). The mean±SD preoperative intraocular pressure (IOP) was 29.13±3.3 and 29.89±3.2 mm Hg in the VCST and VT groups, respectively (P=0.292) and 11.9±1.3 and 13.8±1.2 mm Hg at the end of 36 moths of follow-up (P<0.001). The IOP at all follow-up time points (except at the third month, P=0.924) was statistically significantly less in the VCST group than in the VT group (at week 1, month 1, 6, 9, 12, 18, 24, 30, and 36 the P<0.001). The cumulative probability of success was 100%, 95%, 90%, and 90%, respectively in VSCT and 100%, 72.7%, 97.7%, 90.9%, and 84% in VT at 12, 24, 30, and 36 months.

CONCLUSIONS

Both VCST and VT were effective and safe for lowering the IOP in PCG with VCST providing a marginal advantage over VT.

Intravitreal Ranibizumab With Panretinal Photocoagulation Followed by Trabeculectomy Versus Visco-Trabeculotomy in Management of Neovascular Glaucoma

PURPOSE

The aim of the current study was to compare visco-trabeculotomy (VT) with standard trabeculectomy with mitomycin C (Trab-MMC) in the treatment of quiescent neovascular glaucoma (NVG).

METHODS

The study was conducted on 51 eyes of 51 patients presenting with NVG and treated at an Ophthalmic Center in Egypt between March 2014 and April 2017. All study eyes were subjected to a standard protocol of intravitreal injection of ranibizumab followed by panretinal photocoagulation. Eyes were then randomized to either VT or Trab-MMC. Study eyes were followed up for at least 18 months. Success was defined as an intraocular pressure of ≤21 mm Hg and without vision-threatening complications. Complications were noted.

RESULTS

The mean ± SD (range, median) age of the study patients was 54.1 ± 6.4 (40-67, 54.5) and 52.4 ± 8.8 (38-66, 53) years in the VT (26 eyes) and Trab-MMC (25 eyes) groups, respectively (P = 0.45). The mean ± SD (range, median) intraocular pressure (IOP) of the study eyes was 45.19 ± 2.97 (39-52, 45.5) and 45.64 ± 3.56 (3-53, 45) mm Hg on maximal medical therapy in the VT and Trab-MMC groups, respectively (P = 0.61). At 18 months' follow-up, the mean ± SD (range, median) IOP of the study eyes was 18.19 ± 2.0 (16-23, 17) and 19.92 ± 2.6 (18-26, 19) mm Hg in the VT and Trab-MMC groups, respectively (P = 0.004). There was no difference in postoperative antiglaucoma medication between the 2 groups (P = 0.62). Complications included hyphema and Descemet split in the VT group and an IOP spike in the Trab-MMC group. Success rates were 84.6% and 80% in the VT and Trab-MMC groups, respectively (P = 0.726).

CONCLUSIONS

Both VT and Trab-MMC groups are effective in reducing the IOP in cases of NVG after control of neovascularization with anti-vascular endothelial growth factor and pan retinal photocoagulation.

Transconjunctival Cryo-Assisted Extraction of Intraconal Cavernous Hemangioma.. [DOI: 10.21203/rs.2.14177/v4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0]

Background: The aim of this study is to evaluate the safety and efficacy of cryo-assisted transconjunctival orbitotomy for the extraction of intraconal cavernous hemangiomas. Methods: The study was performed at the Mansoura Ophthalmic Center, Mansoura University, Egypt from May 2017 to August 2018 and included 18 patients with orbital intraconal cavernous hemangiomas. In all the cases, preoperative orbital magnetic resonance imaging (MRI) with contrast was performed, the transconjunctival approach was used and cryo-assisted lesion extraction was performed. Cases were followed for six months after the surgery. Results: This study included 18 patients with intraconal cavernous hemangiomas, ten females (55.6%) and eight males (44.4%) with a mean age of 35.6 years. .The hemangiomas were lateral to the optic nerve in eight(44.5%), above the optic nerve in four cases(22.2%), and below the optic nerve in six cases(33.3%). Eight cases had postoperative complications: three cases (16.7%) had postoperative diplopia due to lateral rectus paresis that improved in all three cases within six months, one case (5.6%) had postoperative retrobulbar hemorrhage and proptosis that resolved within two weeks without sequelae, and four cases (22.2%) showed subconjunctival hemorrhages which resolved within two weeks. Of the two cases with preoperative decreases in visual acuity preoperative, one case (5.6%) showed improvement and one case (5.6%) did not improve. Conclusions: Cryoprobe-assisted transconjunctival orbitotomy for the excision of intraconal cavernous hemangiomas is a good approach with minor resolvable complications . Trial registration : Mansoura institutional review board (IRB) Registration number : R/17.05.26 Registration date : 10/5/2017

Transconjunctival Cryo-Assisted Extraction of Intraconal Cavernous Hemangioma.. [DOI: 10.21203/rs.2.14177/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0]

Background The aim of this study is to evaluate the safety and efficacy of transconjunctival cryo-assisted orbitotomy for extraction of intraconal cavernous hemangioma. Methods The study was performed at the Mansoura ophthalmic center, Mansoura University, Egypt from May 2015 to August 2018. It included 18 patients with orbital intraconal cavernous hemangioma. In all cases, preoperative orbital MRI with contrast was performed, transconjunctival approach was used and cryo-assisted extraction of the lesion was performed. Cases were followed for six months after surgery. Results This study included 18 patients with intraconal cavernous hemangioma, ten females (55.6%) and eight males (44.4%) with a mean age 35.6 years. All lesions were located in the intraconal space, eight cases (44.5%) were lateral to the optic nerve, four cases (22.2%) were above the optic nerve, and six cases (33.3%) were below the optic nerve. Postoperative complications included three cases (16.7%) that showed postoperative diplopia due to lateral rectus paresis that improved in all cases within six months, one case (5.6%) that showed postoperative retrobulbar hemorrhage and proptosis that resolved within two weeks without sequelae, and four cases (22.2%) that showed subconjunctival hemorrhage, which resolved within two weeks. Of the two cases with drop of visual acuity preoperative, one case (5.6%) showed improvement of visual acuity and one case (5.6%) did not improve. Conclusions Transconjunctival cryo-assisted extraction of intraconal cavernous hemangioma represents a safe more conservative and effective technique.

Transconjunctival Cryo-Assisted Extraction of Intraconal Cavernous Hemangioma.. [DOI: 10.21203/rs.2.14177/v2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0]

Background: The aim of this study is to evaluate safety and efficacy of transconjunctival cryo-assisted orbitotomy for extraction of intraconal cavernous hemangioma.Methods: The study was performed at the Mansoura ophthalmic center, Mansoura University, Egypt from May 2017 to August 2018, It included 18 patients with orbital intraconal cavernous hemangioma. In all cases, preoperative orbital MRI(magnetic resonance imaging) with contrast was performed, transconjunctival approach was used and cryo-assisted extraction of the lesions was performed. Cases were followed for six months after surgery.Results: This study included 18 patients with intraconal cavernous hemangioma, ten females (55.6%) and eight males (44.4%) with a mean age 35.6 years. Eight cases (44.5%) were lateral to the optic nerve, four cases (22.2%) were above the optic nerve, and six cases (33.3%) were below the optic nerve. Postoperative complications included three cases (16.7%) with postoperative diplopia due to lateral rectus paresis that improved in all cases within six months, one case (5.6%) with postoperative retrobulbar hemorrhage and proptosis that resolved within two weeks without sequelae, and four cases (22.2%) showed subconjunctival hemorrhage which resolved within two weeks. Of the two cases with drop of visual acuity preoperative, one case (5.6%) showed improvement of and one case (5.6%) did not improve. Conclusions: Transconjunctival orbitotomy assisted by the use of the cryoprobe for excision of intraconal cavernous hemangioma represents a good approach with minor resolvable complicationsTrial registration: Mansoura institutional review board (IRB)registration number: R/17.05.26 registration date: 10/5/2017 Keywords: transconjunctival orbitotomy, cryo-assisted extraction of hemangioma, intraconal cavernous hemangioma.

Transconjunctival Cryo-Assisted Extraction of Intraconal Cavernous Hemangioma.. [DOI: 10.21203/rs.2.14177/v3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0]

Background: The aim of this study is to evaluate the safety and efficacy of cryo-assisted transconjunctival orbitotomy for the extraction of intraconal cavernous hemangiomas.Methods: The study was performed at the Mansoura Ophthalmic Center, Mansoura University, Egypt from May 2017 to August 2018 and included 18 patients with orbital intraconal cavernous hemangiomas. In all the cases, preoperative orbital magnetic resonance imaging (MRI) with contrast was performed, the transconjunctival approach was used and cryo-assisted lesion extraction was performed. Cases were followed for six months after the surgery.Results: This study included 18 patients with intraconal cavernous hemangiomas, ten females (55.6%) and eight males (44.4%) with a mean age of 35.6 years. .The hemangiomas were lateral to the optic nerve in eight(44.5%), above the optic nerve in four cases(22.2%), and below the optic nerve in six cases(33.3%). Eight cases had postoperative complications: three cases (16.7%) had postoperative diplopia due to lateral rectus paresis that improved in all three cases within six months, one case (5.6%) had postoperative retrobulbar hemorrhage and proptosis that resolved within two weeks without sequelae, and four cases (22.2%) showed subconjunctival hemorrhages which resolved within two weeks. Of the two cases with preoperative decreases in visual acuity preoperative, one case (5.6%) showed improvement and one case (5.6%) did not improve. Conclusions: Cryoprobe-assisted transconjunctival orbitotomy for the excision of intraconal cavernous hemangiomas is a good approach with minor resolvable complications.Trial registration: Mansoura institutional review board (IRB)Registration number: R/17.05.26 Registration date: 10/5/2017

A Comparative Study of Ocular Surface Disease in Childhood Glaucoma

PURPOSE

To evaluate ocular surface disease (OSD) in patients with childhood glaucoma (CG).

METHODS

A multicenter, comparative, cross-sectional study of 41 eyes of 27 patients with CG and 42 eyes of 42 healthy age- and sex-matched controls was conducted between 2021 and 2022. Developmentally delayed children and those having a coexisting systemic illness that might affect the ocular surface were not enrolled. Data collected included glaucoma type, glaucoma medications and surgeries, anterior segment examination, symptom frequency and severity, and tear break-up time (TBUT). Dry eye disease (DED) symptoms were evaluated using an Arabic-language SPEED questionnaire.

RESULTS

The average number of glaucoma medications and surgeries among the 27 patients with CG was 1.17 and 1.4, respectively. TBUT was shorter in patients with CG compared with controls and even shorter when glaucoma medication usage was accounted for. Punctate epithelial erosions were more prevalent in patients with CG and of a higher grade. The severity of all DED parameters, and the prevalence of all DED parameters except for eye fatigue, were greater in patients with CG on the day of questionnaire intake. In addition, each additional glaucoma drop was associated with worse TBUT and ocular surface dryness. All analyses mentioned above were statistically significant ( P < 0.05).

CONCLUSIONS

In this first study to comprehensively evaluate OSD in patients with CG, a significantly greater incidence of OSD signs and symptoms was found in patients with CG compared with a healthy population. Additional study by CG subtype is needed.

Ahmed glaucoma valve implantation with and without Ologen adjuvant in pediatric glaucoma

PURPOSE

To compare outcomes of Ologen augmentation of Ahmed glaucoma valve implantation (AVG) and AGV implantation alone in children operated on for uncontrolled glaucoma.

METHODS

A prospective study was conducted on 33 eyes (18 right eyes) of 33 children (20 males) operated on following failed initial glaucoma surgeries. Eyes were randomized to the AGV or the AGV-Ologen group. The primary outcome was reduction in IOP on 2 years' follow-up in each group. Success was defined as final intraocular pressure (IOP) of 6-20 mm Hg without vision-threatening complications, additional glaucoma operations, or other signs of glaucoma progression.

RESULTS

Mean patient age (range; median) in the AGV-Ologen and AGV groups was 6.5 ± 2.1 years (2.5-10; 6.5) and 6.5 ± 1.9 years (3-9.5; 7), respectively (P = 0.897). Mean follow-up was 42.1 ± 13.7 months (25-64, 41) and 43.3 ± 11.4 (27-62, 42), respectively (P = 0.788). The most common glaucoma diagnosis in each group was primary congenital glaucoma (82.4% and 81.2% resp.). There was significant postoperative reduction in IOP and the number of IOP-lowering medications at 24 months' follow-up (P < 0.0001 and P = 0.002 for AGV-Ologen and AGV, resp.). The AGV-Ologen group demonstrated statistically significantly lower IOP values at all time points than the AGV group. At 24 months, the probability of total success was 77% in AGV-Ologen and 63% in AGV (P = 0.46).

CONCLUSIONS

In our study cohort, AGV implantation was an effective treatment for operated uncontrolled childhood glaucoma for at least 2 years, with Ologen augmentation providing a clear advantage in terms of IOP control, without compromising safety.

Trabeculectomy with Ologen implant versus perfluoropropane gas bubble for open angle glaucoma in pseudophakic eyes

AIM

To evaluate the safety and efficacy of augmented trabeculotomy with Ologen versus perfluoropropane in management of pseudophakic glaucoma.

METHODS

This is a comparative randomized study included 57 pseudophakic eyes of 57 patients with medically uncontrolled open angle glaucoma (OAG). Twenty-nine patients were allocated in group I (trabeculectomy with Ologen; trab-ologen group), while 28 patients were assigned in group II (trabeculectomy with perfluoropropane gas bubble; trab-C3F8 gas bubble group).

RESULTS

The intraocular pressure (IOP) was significantly reduced in both study groups at all postoperative follow up intervals (1wk, 3, 6, 12, 18, 24, 30 and 36mo, P<0.001). The differences between the mean IOP values of both groups remained statistically insignificance during the early 12 months of follow up. However, the trab-ologen group achieved a statistically significant reduction over the trab-C3F8 gas bubble group during the last 24 months of follow up.

CONCLUSION

Augmentation of trabeculectomy with either Ologen implant or perfluoropropane gas bubble are associated with strict long term IOP control and evident safety in medically-uncontrolled pseudophakic eyes with OAG.

The Use of Ologen Implant in Childhood Glaucoma Surgeries: A Review

PURPOSE

This study assesses the effectiveness and safety of using Ologen implants (Aeon Astron Europe BV, Leiden, The Netherlands) as an adjunctive therapy in childhood glaucoma surgeries.

METHODS

We systematically reviewed the existing literature across various electronic databases to examine the effectiveness and safety of Ologen implants in childhood glaucoma surgeries.

RESULTS

Our analysis encompassed 14 studies on the use of Ologen implants in childhood glaucoma. Among these, seven were prospective, five were retrospective, and two did not specify their study design. Success rates varied depending on the type of surgery and the included childhood glaucoma subtype. The success rates for Ologen implants-augmented surgeries were as follows: 33.3-70% for trabeculectomy, 50-81% for combined trabeculotomy-trabeculectomy procedure, 33%-87% for glaucoma drainage device, and 60% in deep sclerectomy.

CONCLUSION

Ologen implant has a potential role in mitigating postoperative fibrosis and enhancing success rates in various childhood glaucoma surgeries. However, the existing literature is limited. Future comparative prospective studies with larger cohorts are needed.

Visco-Circumferential-Suture-Trabeculotomy Versus Rigid-Probe Viscotrabeculotomy in Neonatal-Onset Primary Congenital Glaucoma

PRCIS

Angle procedures are safe and relatively effective for neonatal onset PCG. Watchful delay in intervention to close to the second month of life is helpful in ensuring diagnosis and making surgery more successful and easier.

PURPOSE

The purpose of this study was to compare the surgical outcomes of visco-circumferential-suture-trabeculotomy (VCST) to rigid-probe double-entry viscotrabeculotomy (DEVT) and rigid-probe single-entry viscotrabeculotomy (SEVT) in infants with neonatal-onset primary congenital glaucoma (PCG).

DESIGN

This was a retrospective chart review.

PATIENTS AND METHODS

Retrospective chart review of 64 eyes of 64 infants with neonatal-onset PCG referred to Mansoura Ophthalmic Center in Mansoura, Egypt between February 2008 and November 2018. Study groups included VCST, DEVT, and SEVT, and follow-up covered 4 postoperative years. Complete (qualified) success was defined as intraocular pressure (IOP) ≤18 mm Hg and with 35% IOP reduction from baseline without (with) IOP-lowering medications or further surgical interventions, and without any sign of progression in corneal diameter, axial length, or optic disc cupping and without visual devastating complications.

RESULTS

The mean±SD age at presentation and at the surgery of the study children was 3.63±1.74 and 55.23±1.60 days, respectively. The mean±SD IOP and cup/disc ratio of all study eyes at presentation and at final follow-up were 34.91±0.82 mm Hg and 0.70±0.09 and 17.04±0.74 mm Hg and 0.63±0.08, respectively. Complete success was achieved in 54.5%, 43.5%, and 31.6% in the VCST, DEVT, and SEVT groups, respectively. A self-limited hyphema was the commonest complication in all groups.

CONCLUSIONS

Angle procedures are safe and marginally effective for the surgical treatment of neonatal-onset PCG, bringing IOP under control for at least 4 years of follow-up. Circumferential trabeculotomy as a first-line treatment has more favorable outcomes than rigid-probe SEVT. Rigid-probe viscotrabeculotomy offers an alternative to the noncompleted circumferential procedure.

Transconjunctival Cryo-Assisted Extraction of Intraconal Cavernous Hemangioma.. [DOI: 10.21203/rs.2.14177/v5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0]

Background: The aim of this study is to evaluate the safety and efficacy of cryo-assisted transconjunctival orbitotomy for the extraction of intraconal cavernous hemangiomas.Methods: The study was performed at the Mansoura Ophthalmic Center, Mansoura University, Egypt from May 2017 to August 2018 and included 18 patients with orbital intraconal cavernous hemangiomas. In all the cases, preoperative orbital magnetic resonance imaging (MRI) with contrast was performed, the transconjunctival approach was used and cryo-assisted lesion extraction was performed. Cases were followed for six months after the surgery.Results: This study included 18 patients with intraconal cavernous hemangiomas, ten females (55.6%) and eight males (44.4%) with a mean age of 35.6 years. .The hemangiomas were lateral to the optic nerve in eight(44.5%), above the optic nerve in four cases(22.2%), and below the optic nerve in six cases(33.3%). Eight cases had postoperative complications: three cases (16.7%) had postoperative diplopia due to lateral rectus paresis that improved in all three cases within six months, one case (5.6%) had postoperative retrobulbar hemorrhage and proptosis that resolved within two weeks without sequelae, and four cases (22.2%) showed subconjunctival hemorrhages which resolved within two weeks. Of the two cases with preoperative decreases in visual acuity preoperative, one case (5.6%) showed improvement and one case (5.6%) did not improve. Conclusions: Cryoprobe-assisted transconjunctival orbitotomy for the excision of intraconal cavernous hemangiomas is a good approach with minor resolvable complications.Ethics approval : Mansoura institutional review board (IRB)Registration number: R/17.05.26Registration date: 10/5/2017Trial Registration:Name of registry: ISRCTN RegisterTrial registration number: ISRCTN45970569Retrospectively registered on 24/4/2020

One-year results of double site versus single site rigid probe viscotrabeculotomy in primary congenital glaucoma

STUDY PURPOSE

to compare single- site viscotrabeculotomy in one eye and double-site rigid probe viscotrabeculotomy in the other eye of the same patient with Primary congenital glaucoma to evaluate the effect of the extent of angle treatment on success rate in the study's locality.

PATIENTS AND METHODS

This prospective randomized study included 70 eyes of 35 children diagnosed with bilateral PCG who attended Mansoura Ophthalmic Center from June 2021 to July 2023. For each patient, one eye underwent single-site rigid probe viscotrabeculotomy (Group S: 35 eyes) and the fellow eye underwent double- site rigid probe viscotrabeculotomy (Group D: 35 eyes). At one-year follow up, complete success was defined as IOP >5 mmHg and ≤16 mmHg without any further IOP-lowering medications and qualified success when IOP ≤16 mmHg with using IOP-lowering medications. Failure was defined as IOP more than 16 mmHg despite the use of IOP-lowering medications, the need for other glaucoma surgery to control IOP or hypotony.

RESULTS

Single-site rigid probe viscotrabeculotomy showed a one-year complete success rate of 88.57% and for double-site viscotrabeculotomy was 91.43% but the difference was not statistically significant (p-value 0.9). There were no major complications in both groups, hyphema was the most common complication and was self-limited.

CONCLUSION

Single-site viscotrabeculotomy shows comparable results to double-site viscotrabeculotomy in PCG preserving more than half of the angle in the former for a second possible angle surgery in recurrent cases.

Viscotrabeculotomy versus trabeculectomy in the surgical treatment of open angle glaucoma: a single center, randomised controlled trial

PURPOSE

The aim of the study was to compare the effect of viscotrabeculotomy and the effect of trabeculectomy on the intraocular pressure (IOP) in cases of open angle glaucoma (OAG).

STUDY DESIGN

Prospective comparative study.

PATIENTS AND METHODS

The study was conducted on 148 eyes of 148 patients (87 men) presenting with and operated upon for OAG at Mansoura Ophthalmic center of Mansoura University in Mansoura, Egypt from 2012 to 2016. Patients were randomized into viscotrabeculotomy and trabeculectomy groups. Postoperative follow up visits were scheduled at weeks 1 and 2 then months 1, 2, 3, 6, 9, 12, 15, 18, 21 and 24. Complications were noted and managed according to needs. The primary outcome measure was IOP.

RESULTS

The study was conducted on 148 eyes (74 right) of 148 patients (87 men). The mean ± SD (range, median) age of the study patients was 50.1 ± 11.5 (20-67, 53) and 51.1 ± 10.0 (27-65, 54.5) years respectively. The mean ± SD (range, median) IOP of the study eyes on maximal tolerated IOP lowering therapy was 23.15 ± 2.31 (19-30, 23.0) and 23.64 ± 1.87 (20-28, 23.0) mmHg respectively and at the end of the 24 months of follow up was 14.91 ± 2.4 (12-23, 14) and 16.64 ± 2.8 (14-25, 16) mmHg respectively (p =  < 0.0005). Notable complications included a mild hyphema in the viscotrabeculotomy group and an IOP spike in the trabeculectomy group.

CONCLUSIONS

Viscotrabeculotomy and trabeculectomy showed efficacy and safety in OAG patients. The former resulted in better IOP reduction.