title: Surgical outcome of safe surgery system trabeculectomy combined with cataract extraction.
abstract: OBJECTIVE
  To determine the efficacy of safe surgery system trabeculectomy combined with manual small incision cataract surgery/phacoemulsification in primary glaucoma coexistent with cataract.
  
  
  METHODS
  This is a retrospective analysis of 105 cases who underwent single-site combined surgery between January 2008 and December 2009. Safe surgery system trabeculectomy with diffuse and posterior application of mitomycin C was performed in all cases. Cataract extraction was done either by Manual Small Incision Cataract Surgery (MSICS) or phacoemulsification. Main outcome measures were success rate of trabeculectomy, as determined by four different IOP goals and incidence of postoperative complications. Analysis was performed using R-2.15, and the significance was tested at 5% level.
  
  
  RESULTS
  The minimum follow-up period was 12 months. The overall success rates (with or without medication) when safe surgery system trabeculectomy was combined with MSICS were 91, 70, and 51% for IOP ≤18, ≤15, and ≤12 mm Hg, respectively, and target IOP was achieved in 72% cases. The mean IOP reduction was 43.8% with MSICS and 42.08% with phacoemulsification. The surgical outcome was not significantly different for both techniques. Postoperative complications were infrequent and comparable.
  
  
  CONCLUSIONS
  The Safe Surgery System Trabeculectomy combined with cataract surgery offers excellent IOP control with minimal postoperative complications. It offers an effective and improved solution for primary glaucoma coexistent with cataract found in developing countries.
authors.affiliation: Department of Ophthalmology, NKP Salve Institute of Medical Sciences and Lata Mangeshkar Hospital, Nagpur, India.
authors.forename: R R
authors.initials: RR
authors.lastname: Khandelwal
authors.affiliation: MDS Bioanalytics, Nagpur, India.
authors.forename: D
authors.initials: D
authors.lastname: Raje
authors.affiliation: Department of Ophthalmology, NKP Salve Institute of Medical Sciences and Lata Mangeshkar Hospital, Nagpur, India.
authors.forename: A
authors.initials: A
authors.lastname: Rathi
authors.affiliation: Department of Ophthalmology, NKP Salve Institute of Medical Sciences and Lata Mangeshkar Hospital, Nagpur, India.
authors.forename: A
authors.initials: A
authors.lastname: Agashe
authors.affiliation: Department of Ophthalmology, NKP Salve Institute of Medical Sciences and Lata Mangeshkar Hospital, Nagpur, India.
authors.forename: M
authors.initials: M
authors.lastname: Majumdar
authors.affiliation: Department of Ophthalmology, NKP Salve Institute of Medical Sciences and Lata Mangeshkar Hospital, Nagpur, India.
authors.forename: R
authors.initials: R
authors.lastname: Khandelwal
mesh_terms: D000477:Alkylating Agents / Q000008:administration & dosage; D002386:Cataract / Q000150:complications / Q000628:therapy*; D002387:Cataract Extraction / Q000379:methods*; D005260:Female; D015812:Glaucoma, Angle-Closure / Q000150:complications / Q000601:surgery*; D005902:Glaucoma, Open-Angle / Q000150:complications / Q000601:surgery*; D006801:Humans; D007429:Intraocular Pressure / Q000502:physiology; D007431:Intraoperative Complications; D008297:Male; D008875:Middle Aged; D016685:Mitomycin / Q000008:administration & dosage; D018918:Phacoemulsification; D011183:Postoperative Complications; D012189:Retrospective Studies; D014130:Trabeculectomy / Q000379:methods*; D016896:Treatment Outcome; D014792:Visual Acuity / Q000502:physiology
chemical_list: D000477:Alkylating Agents; D016685:Mitomycin