부산대학교 도서관

BackgroundTo evaluate the outcomes of combined viscotrabeculotomy–trabeculectomy in patients with refractory developmental glaucoma and to compare the success and complication rates with classical trabeculotomy–trabeculectomy procedure.Patients and MethodsPatients who were selected for this study had cloudy corneas with a diameter of 13 mm or greater and with an initial intraocular pressure (IOP) of 27 mmHg or more, and they were divided into two groups. Group 1 consisted of 40 eyes of 24 patients who had undergone combined viscotrabeculotomy–trabeculectomy with a mean follow-up time of 55.6±18.4 months, and group 2 consisted of 35 eyes of 20 patients who had undergone classical trabeculotomy–trabeculectomy with a mean follow-up time of 57.2±19.0 months. Pre- and postoperative IOPs, mean antiglaucoma medication, mean corneal diameter, success rates, intra- and postoperative complications were compared between two groups.ResultsMean IOP reduced from a preoperative level of 33.2±5.3 and 32.8 mmHg to 14.2±3.1 and 15.3±3.3 in group 1 and group 2, respectively (P<0.001). The mean number of antiglaucoma medications used after surgery was significantly lower in group 1 (P<0.05). Kaplan–Meier survival analysis showed that the success probability at the last visits was 90 and 71.4% in group 1 and group 2, respectively, and the difference was statistically significant (P=0.01). The most common early postoperative complication was transient IOP elevation in group 1 and hyphema in group 2 (for each, P<0.001).ConclusionUse of viscoelastic materials during trabeculotomy–trabeculectomy may increase the success rate of the procedure by prevention of postoperative hemorrhage, anterior chamber shallowing, adhesion of the incision lips or fibroblastic proliferation. [ABSTRACT FROM AUTHOR]