[Combined glaucoma and cataract operation with foldable posterior chamber lens implantation. Long-term outcome and complications].
BACKGROUND
Glaucoma patients who need filtering surgery very often have cataracts as well. Combined glaucoma/cataract surgery entails a higher rate of complications and may endanger the results of glaucoma surgery.


METHODS
This retrospective study investigated 223 eyes in 169 patients with uncontrolled glaucoma and cataracts. Each eye received filtering surgery and simultaneous phacoemulsification with implantation of a foldable posterior chamber lens. Mean follow-up was 32.5 months (6-57).


RESULTS
Mean intraocular pressure was lowered from 24.6 +/- 6.2 to 16.4 +/- 3.4 mmHg (P > 0.0001). Visual acuity improved from 0.25 (0.01-0.5) to 0.5 (0.01-1.0). Preoperatively the mean number of medications was 2.4 (1-6) and postoperatively 1.3 (1 or 2). The most common perioperative complications were choroidal detachment (20.2%) and fibrin reaction in 10.1%; those occurring later than 4 weeks postoperatively were posterior capsule opacification requiring YAG laser capsulotomy (11.5%) and scarring of filtering bleb (7.7%).


CONCLUSIONS
Complications encountered in the combined procedure were due mainly due to cataract surgery of glaucomatous eyes with narrow pupils and posterior synechiae. A shallow anterior chamber occurred in only one case. Despite complications the success rate in lowering intraocular pressure was comparable to that observed in filtering surgery alone.
Quentin
C D
CD
Abteilung Augenheilkunde, Universität Göttingen.
Dittmer
K
K
Lauritzen
K
K
Langer
F
F
Vogel
M
M
D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D018463:Filtering Surgery; D005500:Follow-Up Studies; D005901:Glaucoma / Q000601:surgery*; D006801:Humans; D007910:Lenses, Intraocular; D008297:Male; D008875:Middle Aged; D018918:Phacoemulsification; D011183:Postoperative Complications / Q000209:etiology*; D012189:Retrospective Studies; D016896:Treatment Outcome