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

Abstract

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.

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Fig. 1

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Correspondence to Nader H. L. Bayoumi.

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Conflicts of interest

A. S. Elwehidy, None; T. H. Mokbel, None; N. H. L. Bayoumi, None; A. E. Badawi, None; S. M. Hagras, None.

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Corresponding Author: Nader Bayoumi

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Elwehidy, A.S., Mokbel, T.H., Bayoumi, N.H.L. et al. Viscotrabeculotomy versus trabeculectomy in the surgical treatment of open angle glaucoma: a single center, randomised controlled trial. Jpn J Ophthalmol 65, 395–401 (2021). https://doi.org/10.1007/s10384-020-00801-9

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Keywords

  • Primary open angle glaucoma
  • Viscotrabeculotomy
  • Trabeculectomy
  • Filtering surgery
  • Angle surgery