Primary viscocanalostomy versus trabeculectomy in white patients with open-angle glaucoma - A randomized clinical trial

Purpose: To compare viscocanalostomy, a nonpenetrating procedure for glaucoma treatment, with trabeculectomy. Design: Randomized controlled trial. Participants: Twenty white subjects (20 eyes) with open-angle glaucoma with no history of surgery were enrolled. Methods: Ten subjects were randomly assigned to viscocanalostomy according to Stegmann's technique and 10 subjects to a modified Cairns trabeculectomy. A complete ophthalmologic examination was performed the day before surgery and postoperatively. Further visits were scheduled monthly for 6 to 8 months after surgery. Main Outcome Measures: Success was defined as intraocular pressure (IOP) between 7 and 20 mmHg, with no medication. Results: After a mean follow-up of 6 months (range, 6-8 months), success was obtained in 5 of 10 cases in the trabeculectomy group and in no case in the viscocanalostomy group. With Kaplan-Meier's method, subjects with viscocanalostomy showed shorter postoperative IOP-reduction periods than subjects undergoing trabeculectomy. Conclusions: According to the results of this short-term study, trabeculectomy was more effective than viscocanalostomy in lowering IOP in glaucomatous eyes of white patients. Ophthalmology 2001;108:254-258 (C) 2001 by the American Academy of Ophthalmology.