{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,16]],"date-time":"2026-02-16T07:04:26Z","timestamp":1771225466946,"version":"3.50.1"},"reference-count":32,"publisher":"Knowledge E DMCC","license":[{"start":{"date-parts":[[2026,2,16]],"date-time":"2026-02-16T00:00:00Z","timestamp":1771200000000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["knepublishing.com"],"crossmark-restriction":true},"short-container-title":["JOVR"],"abstract":"<jats:p>Purpose: To compare the outcomes of combined phacoemulsification and viscocanalostomy with versus without intrascleral implantation of Ahmed glaucoma valve (AGV) tube remnants in patients with primary open-angle glaucoma (POAG) and cataract.\n Methods: A randomized clinical trial involving 60 patients with cataract and POAG was carried out. The case group underwent phacoemulsification and viscocanalostomy together with intrascleral implantation of AGV tube remnants, while the control group underwent the same procedures without any implant. The two groups were compared in terms of best-corrected visual acuity (BCVA), intraocular pressure (IOP), cup-to-disc ratio, number of ocular hypotensive medications, surgical success rate, and scleral lake size.\n Results: Sixty patients were enrolled and equally divided into two groups. Postoperative IOP, BCVA, and cup-to-disc ratio did not differ significantly between the groups (P = 0.196, P = 0.724, and P = 0.443, respectively). Despite comparable IOP outcomes, the case group required a significantly higher number of ocular hypotensive medications at the final follow-up (P = 0.043). Anterior segment optical coherence tomography (AS-OCT) revealed significantly larger scleral lake dimensions in the case group in terms of length, height, surface area, and perimeter (all P \u2264 0.001).\nConclusion: Our study found no significant difference in success rates or postoperative IOP control between combined phacoemulsification and viscocanalostomy with or without silicone implants. Although the case group demonstrated larger scleral lake dimensions on AS-OCT, this anatomical difference did not translate into superior IOP outcomes and was associated with a higher requirement for postoperative ocular hypotensive medications. The clinical significance of increased scleral lake size in the presence of an implant remains uncertain, and longer-term follow-up is warranted.<\/jats:p>","DOI":"10.18502\/jovr.v21.17712","type":"journal-article","created":{"date-parts":[[2026,2,16]],"date-time":"2026-02-16T06:04:15Z","timestamp":1771221855000},"page":"1-10","update-policy":"https:\/\/doi.org\/10.18502\/knecrossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Phacoemulsification and Viscocanalostomy With or Without Silicone Implant in Primary Open-angle Glaucoma: A Randomized Clinical Trial"],"prefix":"10.18502","volume":"21","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5668-8196","authenticated-orcid":false,"given":"Saeed","family":"Shokouhi Rad","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-9040-3894","authenticated-orcid":false,"given":"Ali Bagheri","family":"Asl","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6479-1636","authenticated-orcid":false,"given":"Shabnam","family":"Niroumand","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2811-9073","authenticated-orcid":false,"given":"Hamid Reza","family":"Heidarzadeh","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"7770","published-online":{"date-parts":[[2026,2,16]]},"reference":[{"key":"324371","doi-asserted-by":"crossref","unstructured":"1. 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Innovative usage of the remaining portion of Ahmed glaucoma valve tube as an implant in nonpenetrating glaucoma surgery. Oman J Ophthalmol 2020;13:40-42.","DOI":"10.4103\/ojo.OJO_11_2019"},{"key":"324386","unstructured":"16. Stegmann R. Visco-canalostomy: A new surgical technique for open angle glaucoma. An Inst Barraquer 1995;25:229-232."},{"key":"324387","doi-asserted-by":"crossref","unstructured":"17. Shaarawy T, Nguyen C, Schnyder C, Mermoud A. Five year results of viscocanalostomy. Br J Ophthalmol 2003;87:441- 445.","DOI":"10.1136\/bjo.87.4.441"},{"key":"324388","doi-asserted-by":"crossref","unstructured":"18. Johnson DH, Johnson M. How does nonpenetrating glaucoma surgery work? Aqueous outflow resistance and glaucoma surgery. J Glaucoma 2001;10:55-67.","DOI":"10.1097\/00061198-200102000-00011"},{"key":"324389","doi-asserted-by":"crossref","unstructured":"19. Chiou AG, Mermoud A, Underdahl JP, Schnyder CC. An ultrasound biomicroscopic study of eyes after deep sclerectomy with collagen implant. Ophthalmology 1998;105:746-750.","DOI":"10.1016\/S0161-6420(98)94033-7"},{"key":"324390","doi-asserted-by":"crossref","unstructured":"20. Delarive T, Rossier A, Rossier S, Ravinet E, Shaarawy T, Mermoud A. Aqueous dynamic and histological findings after deep sclerectomy with collagen implant in an animal model. Br J Ophthalmol 2003;87:1340-1344.","DOI":"10.1136\/bjo.87.11.1340"},{"key":"324391","doi-asserted-by":"crossref","unstructured":"21. Cillino S, Di Pace F, Cillino G, Casuccio A. Biodegradable collagen matrix implant vs mitomycin-C as an adjuvant in trabeculectomy: A 24-month, randomized clinical trial. Eye 2011;25:1598-1606.","DOI":"10.1038\/eye.2011.219"},{"key":"324392","doi-asserted-by":"crossref","unstructured":"22. Narayanaswamy A, Perera SA, Htoon HM, Hoh ST, Seah SK, Wong TT, et al. Efficacy and safety of collagen matrix implants in phacotrabeculectomy and comparison with mitomycin C augmented phacotrabeculectomy at 1 year. Clin Exp Ophthalmol 2013;41:552-560.","DOI":"10.1111\/ceo.12058"},{"key":"324393","doi-asserted-by":"crossref","unstructured":"23. Johnson MS, Sarkisian SR Jr. Using a collagen matrix implant (Ologen) versus mitomycin-C as a wound healing modulator in trabeculectomy with the Ex-PRESS mini glaucoma device: A 12-month retrospective review. J Glaucoma 2014;23:649-652.","DOI":"10.1097\/IJG.0000000000000018"},{"key":"324394","doi-asserted-by":"crossref","unstructured":"24. Rosentreter A, Mellein AC, Konen WW, Dietlein TS. Capsule excision and Ologen implantation for revision after glaucoma drainage device surgery. Graefes Arch Clin Exp Ophthalmol 2010;248:1319-1324.","DOI":"10.1007\/s00417-010-1385-y"},{"key":"324395","doi-asserted-by":"crossref","unstructured":"25. Demailly P, Lavat P, Kretz G, Jeanteur-Lunel MN. Nonpenetrating deep sclerectomy (NPDS) with or without collagen device (CD) in primary open-angle glaucoma: middle-term retrospective study. Int Ophthalmol 1996- 1997;20:131-140.","DOI":"10.1007\/BF00212959"},{"key":"324396","doi-asserted-by":"crossref","unstructured":"26. Abelson MB, Welch DL. An evaluation of onset and duration of action of patanol (olopatadine hydrochloride ophthalmic solution 0.1%) compared to Claritin (loratadine 10 mg) tablets in acute allergic conjunctivitis in the conjunctival allergen challenge model. Acta Ophthalmol Scand Suppl 2000;78:60-63.","DOI":"10.1034\/j.1600-0420.2000.078s230060.x"},{"key":"324397","doi-asserted-by":"crossref","unstructured":"27. Marchini G, Marraffa M, Brunelli C, Morbio R, Bonomi L. Ultrasound biomicroscopy and intraocular-pressurelowering mechanisms of deep sclerectomy with reticulated hyaluronic acid implant. 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Cheng JW, Cai JP, Li Y, Wei RL. Intraoperative mitomycin C for nonpenetrating glaucoma surgery: A systematic review and meta-analysis. J Glaucoma 2011;20:322-326.","DOI":"10.1097\/IJG.0b013e3181e3d2f7"},{"key":"324402","doi-asserted-by":"crossref","unstructured":"32. Mearza AA, Aslanides IM. Uses and complications of mitomycin C in ophthalmology. 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