Viscocanalostomy: A Pilot Study

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Abstract
Purpose: Viscocanalostomy is a new, non-penetrating procedure for glaucoma surgery. We started a prospective study to assess the effectiveness and safety of the operation. Materials and methods: Up to March 1998 we enrolled 33 patients (33 eyes) suffering from glaucoma, uncontrolled despite maximum medical therapy, who underwent viscocanalostomy according to Stegmann's technique. A complete ophthalmological examination was performed the day before surgery and on days 1 and 7 postoperatively. Further visits were scheduled at months 1, 3, 6 and 12. Results: In four eyes Schlemm's canal was either missed or not deroofed properly, and the procedure was converted into simple trabeculectomy. After a mean follow-up of 3.0±2.6 months (range 1–10), success defined as IOP > 2 and < 21 mmHg with no medication was obtained in 86.2% of the cases (25/29); 23 out of 29 eyes (79.3%) had IOP > 2 and < 16 mmHg. In the 25 successful eyes, mean IOP was 27.7±9.5 mmHg (range 13–48) preoperatively and 12.0±3.0 mmHg (range 7–18) (p<0.0001) at the end of the follow-up period. Mean VA ranged from 0.35±0.34 to 0.32±0.32 (n.s.). Intraoperative complications included: Descemet rupture (7), with iris plugging in two cases; choroidal deroofing (3), irregular incision of Schlemm's canal (2). Postoperative complications included: self-resolving 2-mm hyphema (4); IOP spike (1); inadvertent filtering bleb (2); hypotony with choroidal detachment for one week (1). Conclusions: In this short-term study, viscocanalostomy proved effective and safe in lowering IOP in glaucomatous eyes.

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