[Mid-term effects of two-site phacotrabeculectomy with limbal-based conjunctival flap and microincision trabeculectomy with adjustable sutures].
OBJECTIVE
To evaluate the midterm effects of two-site phacotrabeculectomy with limbal-based conjunctival flap and microincisinal trabeculectomy with adjustable sutures.


METHODS
and method: The charts of 115 patients (188 eyes) were retrospectively reviewed. Patients had a mean age of 74.7 years and were all operated by the same surgeon between 2001 and 2003. The surgery consisted of a clear cornea phacoemulsification and a microtrabeculectomy with limbal-based conjunctival flap. The number of sutures on the scleral flap was adjusted according to the filtration.


RESULTS
The mean preoperative IOP was 17.7 +/- 3.94 mmHg, and the mean number of antiglaucomatous medications was 2.05 +/- 0.86. The last postoperative IOP was 13.2 +/- 2.81 mmHg with a mean of 0.8 +/- 0.8 medications. Mean follow-up was 29.8 months (1-7 years). Visual acuity improved by at least two lines in 154 eyes (81%), stabilized (+/- 1 line) in 33 eyes (17.37%), and worsened of more than two lines in one eye (1.63%). Early postoperative complications were seven Seidels (3.68%), one shallow anterior chamber (0.55%), three chorioretinal detachments (1.58%), six hyphemas (3.15%), one iris incarceration (0.55%), and eight corneal edemas (4.21%). Late complications were five cases of bleb fibrosis despite needling and 5-FU injection. We had no cases of wipe-out syndrome.


CONCLUSIONS
Our study shows the effectiveness of this special phacotrabeculectomy technique on IOP control and visual acuity improvement, with low complication incidence compared to classical phacotrabeculectomies.
Institut du Glaucome, Fondation Hôpital Saint-Joseph, Paris. yaralteif@hotmail.com
Y
Y
Lteif
R
R
Berete-Coulibaly
A
A
Labbé
W
W
Bouassida
Y
Y
Lachkar
D000368:Aged; D003228:Conjunctiva / Q000601:surgery*; D005260:Female; D005901:Glaucoma / Q000601:surgery*; D006801:Humans; D016850:Limbus Corneae; D008297:Male; D008866:Microsurgery; D012189:Retrospective Studies; D013524:Surgical Flaps; D013536:Suture Techniques; D013997:Time Factors; D014130:Trabeculectomy / Q000379:methods*