[Results after combined phacoemulsification and trabeculectomy by scleral tunnel incision and goniotrepanation alone].
OBJECTIVE
We retrospectively evaluated the results of combined phacoemulsification and trabeculectomy through scleral tunnel incision in comparison with those of goniotrephination alone.


METHODS
27 eyes of 20 patients (78.3 +/- 7.45 years) underwent a combined trabeculectomy and phacoemulsification with IOL-implantation (PT-group). The trabeculectomy was performed by excision of 2 mm middle part of the lower tunnel lip. In comparison with the TP-group 29 eyes of 28 patients (69.3 +/- 8.1 years) underwent a goniotrephination (Fronimopoulos), (G-group). The median of follow up was 8 weeks.


RESULTS
In both groups a significant reduction of the IOP was achieved; in the PT-group the IOP was reduced from 31.0 +/- 5.42 to 15.0 +/- 4.5 mm Hg, in the G-group from 31.4 +/- 6.3 to 11.6 +/- 4.12 mmHg. In the PT-group the visual acuity increased significantly from 0.25 +/- 0.14 to 0.37 +/- 0.27 and decreased significantly from 0.46 +/- 0.28 to 0.32 +/- 0.25 in the G-group. 3 patients (= 11%) needed topical medication in the PT-group and 6 (= 24%) in the G-group. Four patients (= 15%) of the PT-group underwent a secondary surgery and 7 (= 24%) of the G-group.


CONCLUSIONS
The combined phacoemulsification and trabeculectomy is a successful method of IOP control and visual rehabilitation. Due to the decrease of visual acuity and a higher frequency of secondary surgery after goniotrephination alone the combined procedure should be preferred even in presence of a moderately visual acuity reducing cataract.
Gareis
O
O
Universitäts-Augenklinik Ulm.
Wagner
P
P
Lang
G K
GK
D000368:Aged; D000369:Aged, 80 and over; D003131:Combined Modality Therapy; D005260:Female; D005500:Follow-Up Studies; D005901:Glaucoma / Q000601:surgery*; D006801:Humans; D007429:Intraocular Pressure / Q000502:physiology; D007910:Lenses, Intraocular; D008297:Male; D008875:Middle Aged; D018918:Phacoemulsification; D011183:Postoperative Complications / Q000209:etiology* / Q000601:surgery; D012086:Reoperation; D012189:Retrospective Studies; D012599:Sclerostomy; D014130:Trabeculectomy; D014792:Visual Acuity / Q000502:physiology
Ergebnisse nach kombinierter Phakoemulsifikation und Trabekulektomie über Tunnelschnitt und alleiniger Goniotrepanation.