Phacoviscocanalostomy versus cataract surgery only in patients with coexisting normal-tension glaucoma: Midterm outcomes

Purpose To compare the midterm efficacy and safety of phacoviscocanalostomy (viscocanalostomy, phacoemulsification, and intraocular lens [IOL] implantation) and cataract surgery (phacoemulsification and IOL implantation) in patients with normal-tension glaucoma (NTG) and cataract. Setting Sensho-kai Eye Institute, Kyoto, Japan. Methods Thirty-one eyes had phacoviscocanalostomy, and 35 eyes had uncomplicated cataract surgery only. The intraocular pressure (IOP), postoperative antiglaucoma medications, and visual outcomes were compared between groups. Results The mean follow-up was 34.9 months ± 19.8 (SD) (range 7 to 78 months). At 36 months, the mean preoperative IOP and postoperative IOP were 17.2 ± 1.5 mm Hg and 14.1 ± 1.6 mm Hg, respectively, in the phacoviscocanalostomy group and 16.7 ± 1.4 mm Hg and 15.6 ± 3.4 mm Hg, respectively, in the cataract surgery only group. The differences between groups were significant at all time points ( P P P = .024). Conclusion Phacoviscocanalostomy lowered IOP and maintained postoperative visual outcomes; it was safe and effective in elderly patients with coexisting NTG and cataract.