Modified Viscotrabeculotomy with Microcatheter: Our Technique and Experience in the Surgical management of Glaucoma

J Curr Glaucoma Pract. 2019 Sep-Dec;13(3):88-93. doi: 10.5005/jp-journals-10078-1263.

Abstract

Aims: To present the results of our case series with a technique we defined as "modified viscotrabeculotomy" which incorporates the benefits of 360° of trabeculotomy and viscodilation and viscodissection of canal of Schlemm using a microcatheter.

Materials and methods: This study was designed as a prospective interventional case series and was conducted in Cerrahpasa Medical School Ophthalmology Clinic. Forty-one eyes of 30 patients diagnosed with congenital glaucoma (CG) underwent modified viscotrabeculotomy surgery following initial preoperative examination. The main outcome measure was the surgical success of the procedure, which is determined by an intraocular pressure (IOP) of <18 mm Hg without medication or resurgery; qualified success is defined as an IOP of <18 mm Hg under general anesthesia with an additional need for medications. The differences in IOP measurements were analyzed using paired analysis of variance (ANOVA) with repeated measures.

Results: The mean preoperative IOP of the patients was 32.27 ± 4.89 mm Hg. The IOP values at the 1st, 3rd, 6th postoperative months, and at the last visit were 13.41 ± 2.25 mm Hg, 13.70 ± 1.78 mm Hg, 12.47 ± 1.57 mm Hg, and 12.26 ± 1.81 mm Hg, respectively. The difference between the preoperative IOP values and postoperative IOP values was statistically significant (p < 0.001). The qualified surgical success rate was 94.4% after a mean follow-up of 27.95 ± 8.25 months (range 15-45 months).

Conclusion: Modified viscotrabeculotomy is a safe and effective treatment in the management of CG.

How to cite this article: Tamçelik N, Capar O, Atalay E. Modified Viscotrabeculotomy with Microcatheter: Our Technique and Experience in the Surgical management of Glaucoma. J Curr Glaucoma Pract 2019;13(3):88-93.

Keywords: Canaloplasty; Congenital glaucoma; Goniotomy; Microcatheter; Viscotrabeculotomy.