Long-term results of combined trabeculectomy and small incision cataract surgery.
We did a prospective study of 49 eyes (36 patients) with coexisting cataract and glaucoma who had combined trabeculectomy, phacoemulsification, and implantation of a folded polyHema intraocular lens through the trabeculectomy opening. Preoperatively, intraocular pressure (IOP) was controlled (< 20 mm Hg) in 13 eyes on a mean of 2.2 medications and uncontrolled (> 20 mm Hg) in 36 eyes on a mean of 2.4 medications. Preoperative visual acuity ranged from 20/40 to hand movements. At the end of the follow-up, IOP was below 18 mm Hg in all eyes (100%), without therapy in 39 (80%) and with reduced therapy in 8 (16%). Two (4%) eyes were controlled on the same medication regimen. Visual acuity improved in 42 patients (86%); 38 (78%) achieved a visual acuity of 20/40 or better. A filtering bleb was observed in 45 eyes (92%). The most common early postoperative complication was fibrin exudation into the anterior chamber. Late complications included posterior synechias and vision-impairing capsule opacifications. Visual acuity improved after neodymium:YAG laser treatment in all eyes with opacification without further complications. We conclude that the combination of small incision cataract surgery and trabeculectomy is a successful surgical approach for long-term visual rehabilitation and glaucoma control.
Wedrich
A
A
University Eye Hospital Vienna, Department B, Austria.
Menapace
R
R
Radax
U
U
Papapanos
P
P
D000368:Aged; D000369:Aged, 80 and over; D002386:Cataract / Q000150:complications; D002387:Cataract Extraction / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D005901:Glaucoma / Q000150:complications / Q000601:surgery*; D006801:Humans; D007429:Intraocular Pressure; D007910:Lenses, Intraocular; D008137:Longitudinal Studies; D008297:Male; D008689:Methacrylates; D011183:Postoperative Complications; D011379:Prognosis; D011446:Prospective Studies; D013536:Suture Techniques; D014130:Trabeculectomy / Q000379:methods*; D014792:Visual Acuity
D008689:Methacrylates; C005044:hydroxyethyl methacrylate