Evidence Table 19Viscocanalostomy vs. deep sclerectomy

Study detailsPatientsInterventionsOutcome measuresEffect sizeComments
Egrilmez et al, 200440

Study design:

Evidence level:

Duration of follow-up:
6 months
Patient group: COAG

Setting: single setting - Turkey

Inclusion criteria: Exclusion criteria: All patients
N: 34 (34 eyes) randomised
Age (mean): 61.7 ± 10.9
M/F: 21/13
Mean IOP: NR
Drop outs: 4 (2 drop outs and 2 due to cataract surgery)
POAG: 20
PG: 3
PXF: 7
White: 30

Group 1
N: 12
Age (mean): 60.35 ± 12.96
Mean IOP: 31.09 ± 12.53
Drop outs: 1

Group 2
N: 10
Age (mean): 61.25 ± 10.67
Mean IOP: 27.00 ± 5.35
Drop outs: 2 (1 lost to follow up after 1 month and 1 cataract surgery)

Group 3
N: 12
Age (mean): 63.36 ± 9.68
Mean IOP: 27.36 ± 11.26
Drop outs: 1
Group 1
Trabeculectomy (Cairns)

Group 2
NDPS + T-flux non- absorbable implant

Group 3

Examination methods:
Baseline examinations included visual acuity, Humphrey VF measurement, biomicroscopy, gonioscopy, Goldmann tonometry, autokeratorefreactometry and corneal topography.

Measurements of astigmatism, IOP and visual acuity at 1 day, 1 month, 3 months and 6 months

Antimetabolites were not used
Mean IOP ± SD at 6 monthsGroup 1: 15.09 ± 3.36 (n=11)
Group 2: 14.13 ± 2.85 (n=8)
Group 3: 17.28 ± 3.44 (n=8)
p value: 0.103 Kruskal-Wallis test
NR (requested info from author but no response)

Limitations: Additional outcomes:
Visual acuity
Induced astigmatism

*As standard deviations for the change in IOP from baseline were not reported they were imputed using correlation coefficients measuring change from baseline for each arm derived from the study El Sayyad 200041 using the methods detailed in the Cochrane handbook.
Although El Sayyad compares trabeculectomy to deep sclerectomy, the latter intervention was considered similar enough to viscocanalostomy to produce an equivalent effect size.
Mean change in IOP from baseline at 6 monthsGroup 1: 16.0 ± 11.23*
Group 2: 11.91 ± 9.19*
Group 3: 10.08 ± 3.92*
p value: NR

Abbreviations: NR=not reported, NA=not applicable, M/F=male/female, N=total number of patients randomised, SD=Standard Deviation, SE(M)=Standard Error (of the mean), ITTIntention to Treat etc

From: Appendix D, Evidence tables

Cover of Glaucoma
Glaucoma: Diagnosis and Management of Chronic Open Angle Glaucoma and Ocular Hypertension.
NICE Clinical Guidelines, No. 85.
National Collaborating Centre for Acute Care (UK).
Copyright © 2009, National Collaborating Centre for Acute Care.

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