Bimanual microincisional phacoemulsification combined with viscocanalostomy plus deeper sclerectomy.

PURPOSE: The aim of the study was to evaluate the safety and effectiveness of a new technique, two-site bimanual microincisional cataract surgery combined with viscocanalostomy plus deeper sclerectomy (two-site bimanual MICS-VC-DS), in patients with cataract and glaucoma.

DESIGN

Noncomparative, interventional case series.

METHODS

From December 2005 to October 2007, a consecutive series of 12 patients (12 eyes) with uncontrolled primary open angle glaucoma (POAG) and cataract have undergone two-site bimanual MICS-VC-DS. Postoperative evaluation included visual acuity (VA), intraocular pressure (IOP), average retinal nerve fiber layer (RNFL) thickness measurement, and gonioscopic, biomicroscopic, and funduscopic examination. Paired-samples t test was used. A p value of <0.05 was taken as significant.

RESULTS

The mean duration of follow-up was 14.6 months (SD 5.8). At 9 months, mean IOP was 17.0 (SD 4), the mean IOP reduction was 13.2 mmHg (SD 5.86). At 9 months post-surgery, the complete success rate was 75%. Qualified success was achieved in 100% of patients. At 9 months, the mean number of antiglaucoma medications was 0.58 (SD 1.24) (p<0.05). Visual acuity improved by a mean value of 2.8 lines. Average RNFL thickness did not change significantly during the follow-up period (p=0.781).

CONCLUSIONS

Two-site bimanual MICS-VC-DS appears to be an effective and safe procedure with quick visual rehabilitation, acceptable mid-term IOP control, and the advantage of having fewer complications.