title: Managing post acute congestive phase by combined manual small incision cataract surgery and trabeculectomy: a prospective study.
abstract: The purpose of the study was to evaluate the therapeutic efficacy of manual small incision cataract surgery (SICS) and trabeculectomy as management option for acute angle closure glaucoma. The first 6 cases of 14 cases of acute angle closure glaucoma seen over a period of 18 months underwent surgical peripheral buttonhole iridectomy (PBHI) after their intra-ocular pressure (IOP) was controlled medically. Subsequently 8 cases underwent manual SICS+trabeculectomy as an alternative procedure after their IOP control who needed further surgery and overall patients' comfort. The results showed sustained visual acuity remained 6/9 or better in all the patients of SICS + trabeculectomy group, compared 6/12 or worse in the PBHI group. Mean non-contact tonometry reading at the end of 6 weeks was 10.2 mm Hg in the second group compared to 14.6 in the first group. None of the patients in the second group ever needed surgery in a 4-month follow-up, whereas 3 patients in the first group had to be operated again for cataract or uncomplicated IOP. Manual SICS+ trabeculectomy offers a good, economical and rational therapeutic alternative to traditional PBHI in the postcongestive phase.
authors.affiliation: Department of Ophthalmology, Bankura Sammilani Medical College Hospital, Bankura 722102.
authors.forename: M Nazarul
authors.initials: MN
authors.lastname: Islam
authors.forename: Soumen
authors.initials: S
authors.lastname: Chakroborty
authors.forename: Anup
authors.initials: A
authors.lastname: Mondal
authors.forename: Rakhi
authors.initials: R
authors.lastname: Bandopadhay
mesh_terms: D000208:Acute Disease; D000368:Aged; D002387:Cataract Extraction / Q000379:methods*; D005260:Female; D015812:Glaucoma, Angle-Closure / Q000601:surgery*; D006801:Humans; D032801:Iridectomy / Q000379:methods; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D014065:Tonometry, Ocular; D014130:Trabeculectomy; D014792:Visual Acuity