AIM: To evaluate the outcomes, success rate and complications encountered following viscocanalostomy and phacoviscocanalostomy. And to quantify our need, complications and results following Nd:YAG goniopuncture.

METHODS: Data was collected prospectively on eyes undergoing viscocanalostomy or phacoviscocanalostomy and evaluation was carried out at 1 year. In addition Nd:YAG laser goniopuncture(LGP)was performed at any stage for uncontrolled post-operative IOP.

RESULTS: Post-operative data was available for 100 eyes. Eyes achieving complete success(defined as IOP≤18mmHg without any glaucoma medication)was 76%(n=76), and those with a qualified success(defined as a total of eyes with an IOP≤18mmHg without or with 1 permanent glaucoma medications)was 88%(n=88). Sixty-three percent(n=63)of eyes achieved a 30% reduction in IOP without a need for medication and 67%(n=67)in total without or with 1 permanent glaucoma medication. The Kaplan-Meier survival analysis suggests phacoviscocanalostomy is superior at lowering the IOP to less than 18mmHg without medication, log rank test P=0.005. Sixteen eyes required post operative LGP at various time points, a majority(40%)of episodes were around 6 months post surgery. There was a 24.8% post LGP reduction in mean IOP(P=0.0002). For LGP at 12 months an IOP less than 18mmHg without glaucoma treatment was achieved in 94%(n=15)following LGP. All patients maintained a drop in IOP at least 3 months following LGP, longer follow up data was to follow.

CONCLUSION: Our data show viscocanalostomy and phacoviscocanalostomy are highly successful at 1 year. Nd:YAG laser goniopuncture was also efficacious at lowering and maintaining the IOP. Complications were scarce.