Phacotrabeculectomy: comparison of results from 3.5- and 5.2-mm incisions.
OBJECTIVE
To compare the intraocular pressure control, visual results, and astigmatic results of 3.5-mm and 5.2-mm incisions following phacotrabeculectomy with 12 months of follow-up.


METHODS
Fifty eyes underwent clear cornea punch trabeculectomy under a 5.0 x 2.5-mm scleral flap, closed with two 10-0 polyglactin sutures. The first 25 eyes underwent wound extension to 5.2 mm for insertion of a single-piece polymethylmethacrylate (PMMA) lens. The next 25 eyes underwent wound extension to 3.5 mm for insertion of a folded silicone lens.


RESULTS
The mean intraocular pressure decrease from the preoperative level was 7.6 mm Hg in the 3.5-mm incision group and 7.8 mm Hg in the 5.2-mm incision group. One patient required continued medication. The best-corrected visual acuity was 20/40 or better in 86% of the patients, with no significant difference between the groups. The mean "with the wound" induced astigmatism showed no statistical difference between the two groups.


CONCLUSIONS
The use of 10-0 polyglactin appears to aid filtration, yet minimizes hypotony or the need for antimetabolites. For surgeons who wish to reduce costs without compromising results during phacotrabeculectomy, there is merit in considering a 5.2-mm incision; moreover, the more rigid single-piece PMMA lens appears to be associated with fewer complications in the immediate postoperative period.
Vyas
A V
AV
Department of Ophthalmology, Scarborough District Hospital, England.
Bacon
P J
PJ
Percival
S P
SP
D000368:Aged; D000369:Aged, 80 and over; D001251:Astigmatism / Q000209:etiology; D002386:Cataract / Q000150:complications; D005260:Female; D005500:Follow-Up Studies; D005901:Glaucoma / Q000150:complications / Q000601:surgery*; D006801:Humans; D007429:Intraocular Pressure / Q000502:physiology; D019654:Lens Implantation, Intraocular; D007910:Lenses, Intraocular; D008297:Male; D008875:Middle Aged; D018918:Phacoemulsification / Q000009:adverse effects; D019904:Polymethyl Methacrylate; D011183:Postoperative Complications; D011446:Prospective Studies; D012826:Silicone Elastomers; D013536:Suture Techniques; D014130:Trabeculectomy / Q000009:adverse effects; D016896:Treatment Outcome; D014792:Visual Acuity / Q000502:physiology
D012826:Silicone Elastomers; D019904:Polymethyl Methacrylate