title: A comparative study of combined small-incision cataract surgery with sutureless trabeculectomy versus trabeculectomy using W-shaped incision.
abstract: BACKGROUND
  Manual small-incision cataract surgery with trabeculectomy is now an acceptable option in the surgical management of combined cataract and glaucoma uncontrolled with maximum tolerated medical therapy.
  
  
  OBJECTIVE
  To compare the results and complications of combined manual small-incision cataract surgery (SICS) and posterior chamber intraocular lens (PCIOL) implantation with trabeculectomy by sutureless versus W-shaped incision technique.
  
  
  METHODS
  The study included 30 eyes of 28 patients with senile cataract and primary open-angle glaucoma (POAG) who were randomly divided into two groups. The patients in Group A (n = 15) underwent SICS with sutureless trabeculectomy and those in Group B (n =15) underwent SICS with trabeculectomy using W-shaped incision with one suture. Post-operative evaluation was done at the first post-operative day and thereafter on follow-ups at 1 week, 2 weeks, 4 weeks and 8 weeks.
  
  
  RESULTS
  The mean preoperative and postoperative intraocular pressure (IOP) in Group A was 27.33 ± 3.35 mmHg and 16.13 ± 4.30 mmHg respectively and in Group B it was 29.46 ± 6.06 mmHg and 14.66 ± 2.69 mmHg respectively. The mean reduction in IOP after 8 weeks of follow-up in Group A was 12.52 ± 3.59 mmHg and that in Group B was 16.47 ± 3.79 mmHg (p less than 0.001). Besides this, the uncorrected visual acuity (UCVA) was better in Group B postoperatively with less surgically-induced against-the-rule (ATR) astigmatism.
  
  
  CONCLUSIONS
  Combined SICS with trabeculectomy using W-shaped incision offers better prospective in terms of glaucoma control and visual performance than sutureless combined surgery.
authors.affiliation: Regional Institute of Ophthalmology, Post Graduate Institute of Medical Sciences, Rohtak, Haryana, India.
authors.forename: A K
authors.initials: AK
authors.lastname: Khurana
authors.forename: U
authors.initials: U
authors.lastname: Chawla
authors.forename: N
authors.initials: N
authors.lastname: Passi
authors.lastname: Jyoti
authors.lastname: Archana
authors.lastname: Yogesh
mesh_terms: D000368:Aged; D002386:Cataract / Q000150:complications*; D002387:Cataract Extraction / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D005902:Glaucoma, Open-Angle / Q000150:complications* / Q000601:surgery; D006801:Humans; D007429:Intraocular Pressure; D019654:Lens Implantation, Intraocular / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D013536:Suture Techniques; D014130:Trabeculectomy / Q000379:methods*; D016896:Treatment Outcome; D014792:Visual Acuity