[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.
Lteif
Y
Y
Institut du Glaucome, Fondation Hôpital Saint-Joseph, Paris. yaralteif@hotmail.com
Berete-Coulibaly
R
R
Labbé
A
A
Bouassida
W
W
Lachkar
Y
Y
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*