Skip to main content

Advertisement

Log in

Nd:YAG laser goniopuncture in viscocanalostomy: penetration in non-penetrating glaucoma surgery

  • Original paper
  • Published:
International Ophthalmology Aims and scope Submit manuscript

Abstract

The objective was to evaluate the results of Nd:YAG laser goniopuncture after viscocanalostomy and to investigate the rate of penetration in non-penetrating surgery. Results of viscocanalostomy and incidence of goniopuncture were retrospectively investigated in 33 eyes of 33 patients. Success was defined as an intraocular pressure (IOP) below 19 mmHg with an at least 30% decrease compared to the last preoperative measurement. General success rates after a mean follow-up of 33.5 ± 11.3 months were 79 and 46%, with and without medications, respectively. Mean IOP levels, which were 37.7 ± 9.9 mmHg at the diagnosis without treatment and 27.7 ± 11.3 mmHg at the last preoperative measurement with medical treatment, significantly decreased to 12.7 ± 4.8 mmHg at the last follow-up visit (P < 0.001 for both comparisons). Twelve eyes (36%) with IOPs higher than 18 mmHg during follow-up underwent laser goniopuncture. Mean IOP, which was 26.0 ± 4.6 mmHg before goniopuncture, decreased to 11.5 ± 4.0 mmHg immediately after the procedure (P = 0.002). Early goniopunctures (before month 3) were performed in six eyes, and late goniopunctures (after month 10) were performed in the remaining six eyes. Success rates of laser-applied eyes at the last visit were 75 and 33%, with and without medications, respectively (P = 0.568). No significant difference was found between eyes with and without goniopunctures in terms of success rates, IOP levels, and IOP reduction rates. According to the results of this study, laser goniopuncture is indicated in a significant proportion of patients following viscocanalostomy and may substantially improve the outcome of surgery.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1

Similar content being viewed by others

References

  1. Shaarawy T, Mansouri K, Schnyder C et al (2004) Long-term results of deep sclerectomy with collagen implant. J Cataract Refract Surg 30:1225–1231. doi:10.1016/j.jcrs.2003.10.035

    Article  PubMed  Google Scholar 

  2. Stegmann R, Pienaar A, Miller D (1999) Viscocanalostomy for open-angle glaucoma in black African patients. J Cataract Refract Surg 25:316–322. doi:10.1016/S0886-3350(99)80078-9

    Article  CAS  PubMed  Google Scholar 

  3. Goldsmith JA, Ahmed IK, Crandall AS (2005) Nonpenetrating glaucoma surgery. Ophthalmol Clin North Am 18:443–460. doi:10.1016/j.ohc.2005.05.008

    Article  PubMed  Google Scholar 

  4. Johnson DH, Johnson M (2001) How does nonpenetrating glaucoma surgery work? Aqueous outflow resistance and glaucoma surgery. J Glaucoma 10:55–67. doi:10.1097/00061198-200102000-00011

    Article  CAS  PubMed  Google Scholar 

  5. Dietlein TS, Jacobi PC, Luke C et al (2000) Morphological variability of the trabecular meshwork in glaucoma patients: implications for non-perforating glaucoma surgery. Br J Ophthalmol 84:1354–1359. doi:10.1136/bjo.84.12.1354

    Article  CAS  PubMed  Google Scholar 

  6. Takahashi H, Tanito M, Yokoyama M et al (2004) Two cases of intraoperative anterior chamber angle observation using ophthalmic endoscope in viscocanalostomy. Am J Ophthalmol 138:1060–1063. doi:10.1016/j.ajo.2004.06.040

    Article  PubMed  Google Scholar 

  7. Smit BA, Johnstone MA (2002) Effects of viscoelastic injection into Schlemm’s canal in primate and human eyes: potential relevance to viscocanalostomy. Ophthalmology 109:786–792. doi:10.1016/S0161-6420(01)01006-5

    Article  PubMed  Google Scholar 

  8. O’Brart DP, Rowlands E, Islam N et al (2002) A randomised, prospective study comparing trabeculectomy augmented with antimetabolites with a viscocanalostomy technique for the management of open angle glaucoma uncontrolled by medical therapy. Br J Ophthalmol 86:748–754. doi:10.1136/bjo.86.7.748

    Article  PubMed  Google Scholar 

  9. Spiegel D, Schefthaler M, Kobuch K (2002) Outflow facilities through Descemet’s membrane in rabbits. Graefes Arch Clin Exp Ophthalmol 240:111–113. doi:10.1007/s00417-001-0407-1

    Article  PubMed  Google Scholar 

  10. Sunaric-Megevand G, Leuenberger PM (2001) Results of viscocanalostomy for primary open-angle glaucoma. Am J Ophthalmol 132:221–228. doi:10.1016/S0002-9394(01)00972-2

    Article  CAS  PubMed  Google Scholar 

  11. O’Brart DP, Shiew M, Edmunds B (2004) A randomised, prospective study comparing trabeculectomy with viscocanalostomy with adjunctive antimetabolite usage for the management of open angle glaucoma uncontrolled by medical therapy. Br J Ophthalmol 88:1012–1017. doi:10.1136/bjo.2003.037432

    Article  PubMed  Google Scholar 

  12. Drusedau MU, von Wolff K, Bull H et al (2000) Viscocanalostomy for primary open-angle glaucoma: the Gross Pankow experience. J Cataract Refract Surg 26:1367–1373. doi:10.1016/S0886-3350(00)00449-1

    Article  CAS  PubMed  Google Scholar 

  13. Kobayashi H, Kobayashi K, Okinami S (2003) A comparison of the intraocular pressure-lowering effect and safety of viscocanalostomy and trabeculectomy with mitomycin C in bilateral open-angle glaucoma. Graefes Arch Clin Exp Ophthalmol 241:359–366. doi:10.1007/s00417-003-0652-6

    Article  CAS  PubMed  Google Scholar 

  14. Wishart PK, Wishart MS, Porooshani H (2003) Viscocanalostomy and deep sclerectomy for the surgical treatment of glaucoma: a longterm follow-up. Acta Ophthalmol Scand 81:343–348. doi:10.1034/j.1600-0420.2003.00103.x

    Article  PubMed  Google Scholar 

  15. Vesti E, Raitta C (1997) A review of the outcome of trabeculectomy in open-angle glaucoma. Ophthalmic Surg Lasers 28(2):128–132

    CAS  PubMed  Google Scholar 

  16. Tanito M, Park M, Nishikawa M et al (2002) Comparison of surgical outcomes of combined viscocanalostomy and cataract surgery with combined trabeculotomy and cataract surgery. Am J Ophthalmol 134:513–520. doi:10.1016/S0002-9394(02)01601-X

    Article  PubMed  Google Scholar 

  17. Karlen ME, Sanchez E, Schnyder CC et al (1999) Deep sclerectomy with collagen implant: medium term results. Br J Ophthalmol 83:1–2. doi:10.1136/bjo.83.1.6

    Article  Google Scholar 

  18. El Sayyad F, Helal M, El-Kholify H et al (2000) Nonpenetrating deep sclerectomy versus trabeculectomy in bilateral primary open-angle glaucoma. Ophthalmology 107:1671–1674. doi:10.1016/S0161-6420(00)00263-3

    Article  CAS  PubMed  Google Scholar 

  19. Shaarawy T, Karlen M, Schnyder C et al (2001) Five-year results of deep sclerectomy with collagen implant. J Cataract Refract Surg 27:1770–1778. doi:10.1016/S0886-3350(01)01032-X

    Article  CAS  PubMed  Google Scholar 

  20. Ambresin A, Shaarawy T, Mermoud A (2002) Deep sclerectomy with collagen implant in one eye compared with trabeculectomy in the other eye of the same patient. J Glaucoma 11:214–220. doi:10.1097/00061198-200206000-00009

    Article  PubMed  Google Scholar 

  21. Hamel M, Shaarawy T, Mermoud A (2001) Deep sclerectomy with collagen implant in patients with glaucoma and high myopia. J Cataract Refract Surg 27:1410–1417. doi:10.1016/S0886-3350(01)00959-2

    Article  CAS  PubMed  Google Scholar 

  22. Lachkar Y, Neverauskiene J, Jeanteur-Lunel MN et al (2004) Nonpenetrating deep sclerectomy: a 6-year retrospective study. Eur J Ophthalmol 14:26–36

    CAS  PubMed  Google Scholar 

  23. Shaarawy T, Nguyen C, Schnyder C et al (2004) Comparative study between deep sclerectomy with and without collagen implant: long term follow up. Br J Ophthalmol 88:95–98. doi:10.1136/bjo.88.1.95

    Article  CAS  PubMed  Google Scholar 

  24. Shaarawy T, Nguyen C, Schnyder C et al (2003) Five year results of viscocanalostomy. Br J Ophthalmol 87:441–445. doi:10.1136/bjo.87.4.441

    Article  CAS  PubMed  Google Scholar 

  25. Wishart PK, Wishart MS, Choudhary A et al (2008) Long-term results of viscocanalostomy in pseudoexfoliative and primary open angle glaucoma. Clin Experiment Ophthalmol 36:148–155. doi:10.1111/j.1442-9071.2008.01702.x

    Article  PubMed  Google Scholar 

  26. Negri-Aranguren IC, Devoto M, Dolzani D et al (2004) Concave trabeculo-Descemet’s membrane as an early sign of viscocanalostomy failure. J Cataract Refract Surg 30:826–831. doi:10.1016/j.jcrs.2003.08.017

    Article  PubMed  Google Scholar 

  27. Shaarawy T, Flammer J, Smits G et al (2004) Low first postoperative day intraocular pressure as a positive prognostic indicator in deep sclerectomy. Br J Ophthalmol 88:658–661. doi:10.1136/bjo.2003.029926

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Mehmet Numan Alp.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Alp, M.N., Yarangumeli, A., Koz, O.G. et al. Nd:YAG laser goniopuncture in viscocanalostomy: penetration in non-penetrating glaucoma surgery. Int Ophthalmol 30, 245–252 (2010). https://doi.org/10.1007/s10792-009-9312-0

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10792-009-9312-0

Keywords

Navigation