Foldable acrylic versus rigid polymethylmethacrylate intraocular lens in combined phacoemulsification and trabeculectomy.
BACKGROUND
Combined trabeculectomy and phacoemulsification is a widely accepted option in treating patients with glaucoma who also have cataracts. Implantation of a foldable intraocular lens (IOL) in cataract surgery has several theoretical advantages. We performed a study to determine the results of combined phacoemulsification and trabeculectomy with mitomycin C and implantation of either a foldable acrylic or rigid polymethylmethacrylate (PMMA) IOL.


METHODS
Review of the charts of 58 consecutive patients (60 eyes) who underwent combined phacotrabeculectomy for concomitant cataract and glaucoma at a university-affiliated hospital in Montreal between September 2001 and December 2002. Forty-one eyes received a foldable acrylic lens (3.2-mm-wide incision), and 19 eyes received a rigid PMMA lens (5.2-mm-wide incision). Outcome measures included visual acuity, intraocular pressure (IOP) and postoperative complications. The results in the two groups were compared.


RESULTS
There were no differences in baseline characteristics between the two groups. Earlier recovery of visual acuity was noted in the foldable IOL group than in the rigid IOL group (p = 0.013 for the difference at day 7). IOP control was similar in the two groups, as was the incidence of IOP spikes in the early postoperative period.


CONCLUSIONS
The results suggest that combined phacotrabeculectomy with mitomycin C using a foldable acrylic IOL allows for good postoperative IOP control and earlier visual recovery than the same procedure with insertion of a rigid PMMA lens.
Alzafiri
Yousif
Y
Department of Ophthalmology, Maisonneuve-Rosemont Hospital, and the Guy-Bernier Research Centre, Université de Montréal, Montreal, QC.
Harasymowycz
Paul
P
D000368:Aged; D000903:Antibiotics, Antineoplastic / Q000008:administration & dosage; D001672:Biocompatible Materials; D002386:Cataract / Q000150:complications / Q000628:therapy*; D005901:Glaucoma / Q000150:complications / Q000601:surgery*; D006785:Hospitals, University; D006801:Humans; D007429:Intraocular Pressure; D019654:Lens Implantation, Intraocular / Q000379:methods*; D007910:Lenses, Intraocular; D020366:Methylmethacrylate; D016685:Mitomycin / Q000008:administration & dosage; D018918:Phacoemulsification / Q000379:methods*; D019904:Polymethyl Methacrylate; D011183:Postoperative Complications; D014130:Trabeculectomy / Q000379:methods*; D016896:Treatment Outcome; D014792:Visual Acuity / Q000502:physiology
D000903:Antibiotics, Antineoplastic; D001672:Biocompatible Materials; D020366:Methylmethacrylate; D016685:Mitomycin; D019904:Polymethyl Methacrylate