Combined phacoemulsification and filtering surgery with the 'no-stitch' technique.
OBJECTIVE
To determine if intentionally making a radial incision could lead to a lasting decrease in intraocular pressure and the development of filtering blebs.


METHODS
Forty-three eyes treated with combined filtering surgery were compared with a control group of 42 eyes treated with cataract surgery (phacoemulsification) alone. All of the patients had advanced chronic open-angle glaucoma. During combined cataract and glaucoma surgery, the tunnel floor was transected with Vannas scissors.


RESULTS
One year after surgery, the mean intraocular pressure in the study group decreased 7.6 mm Hg from a preoperative mean (+/-SD) of 25.9+/-5.3 mm Hg. The decrease in the control group was 3.7+/-4.2 mm Hg. The difference between the 2 groups was statistically significant (P<.001). In the study group, an average of 1.5+/-0.8 fewer medications were required 1 year after surgery. In the control group, 0.5+/-0.6 fewer medications were required.


CONCLUSIONS
The combined surgical procedure discussed in this article led to a lasting decrease in intraocular pressure. Cataract surgery alone using the no-stitch technique and posterior chamber lens implantation also reduced intraocular pressure, although significantly less.
Anders
N
N
Virchow Hospital Eye Clinic, Humboldt University, Berlin, Germany.
Pham
T
T
Holschbach
A
A
Wollensak
J
J
D000368:Aged; D002386:Cataract / Q000150:complications; D002908:Chronic Disease; D018463:Filtering Surgery / Q000379:methods*; D005500:Follow-Up Studies; D005902:Glaucoma, Open-Angle / Q000150:complications / Q000601:surgery*; D006801:Humans; D007429:Intraocular Pressure; D018918:Phacoemulsification / Q000379:methods*; D011183:Postoperative Complications; D011446:Prospective Studies; D012086:Reoperation; D013536:Suture Techniques; D016896:Treatment Outcome; D014792:Visual Acuity