Phacoviscocanalostomy in pseudoexfoliation glaucoma versus primary open-angle glaucoma

Area of Science:

• Ophthalmology
• Glaucoma Surgery
• Surgical Outcomes

Background:

• Pseudoexfoliation glaucoma (PEXG) and primary open-angle glaucoma (POAG) are leading causes of irreversible blindness.
• Effective surgical management is crucial for controlling intraocular pressure (IOP) and preserving vision in these conditions.
• Phacoviscocanalostomy offers a potential surgical alternative for glaucoma management.

Purpose of the Study:

• To compare the efficacy and safety of phacoviscocanalostomy in patients with PEXG versus POAG.
• To evaluate intraocular pressure (IOP) reduction, need for antiglaucoma medications, visual acuity (VA), and complication rates.

Main Methods:

• A prospective comparative study involving 60 eyes of 60 patients with medically uncontrolled PEXG (30 eyes) or POAG (30 eyes).
• Phacoviscocanalostomy was performed for cataract and glaucoma.
• Success was defined by IOP reduction and decreased need for antiglaucoma medications; VA and complications were secondary outcomes.

Main Results:

• Mean follow-up was 19.7 months. Both PEXG and POAG groups showed significant IOP reduction compared to preoperative levels (p < 0.001).
• IOP decrease was more pronounced in the PEXG group (49.7% reduction) than in the POAG group (30.9% reduction) at the last visit (p < 0.05).
• All patients experienced improved VA and reduced medication needs; transient complications were noted but did not impact outcomes.

Conclusions:

• Phacoviscocanalostomy is an effective and safe surgical option for both PEXG and POAG, achieving excellent IOP control and VA improvement.
• PEXG patients demonstrated superior IOP reduction and required fewer postoperative medications compared to POAG patients.
• The low complication rate supports phacoviscocanalostomy as a viable alternative to phacotrabeculectomy.