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Abstract #12138 Published in IGR 7-1
The long-term effect of phacoemulsification combined with trabeculectomy and intraoperative 5-fluorouracil in glaucoma patients
Cai Y; Lim Z; Lim BA; Oen F; Yan XM; Li MY; Seah SChinese Journal of Ophthalmology 2005; 41: 128-131
OBJECTIVE: This study was designed to evaluate the long-term effect of phacoemulsification, lens implantation combined with trabeculectomy augmented with 5-Fluorouracil (phaco-trab-5-Fu) in Asian glaucoma patients with primary open-angle glaucoma (POAG) and primary angle-closure glaucoma (PACG). METHODS: This retrospective study included 71 consecutive patients who underwent phaco-trab-5-Fu in Singapore National Eye Center between January 1996 and December 1998. Patients with follow-up time less than 6 months were excluded from the study. RESULTS: The mean follow-up time was (53.1 ± 20.9) months. Postoperative IOP was significantly lower than preoperation [(15.0 ± 4.0) mmHg (1 mmHg = 0.133 kPa), (20.3 ± 5.4) mmHg, respectively, P < 0.01]. Postoperative number of antiglaucoma medications was also significantly decreased than preoperation (P < 0.01). IOP of 1 to 5 years postoperation dropped significantly from that of preoperation (P < 0.01). Complete success (CS) rate of phaco-trab-5-Fu was 84.2%, 62.7%, 55.3% for 1, 3, 5 years, respectively. There were neither significant difference found in PACG group and POAG group, or in single-incision and separate-incision of CS rate. But mean IOP of last follow-up was significantly different between PACG and POAG [mean IOP (13.8 ± 4.6) mmHg, (16.2 ± 3.7) mmHg, respectively, P = 0.02]. According to LogMAR chart, mean preoperative visual acuity (VA) and postoperative VA were 0.75 ± 0.40 and 0.46 ± 0.46, respectively. Postoperative VA was significantly improved (P < 0.01). In visual field, MD were (-16.6 ± 8.8) dB and (-17.6 ± 10.1) dB at preoperation and postoperation, respectively. PSD were (6.2 ± 2.9) dB and (6.5 ± 3.2) dB correspondingly. There were no significant difference in both MD and PSD (P = 0.55, 0.64, respectively). One patient had early endophthalmitis and required vitrectomy. Two late-onset of hypotony were due to choroidal effusion and wound leak. CONCLUSIONS: Phacoemulsification combined with trabeculectomy and 5-Fu could be a successful and safe treatment for patients with cataract and primary glaucoma in a long run. There is no difference in success rate in PACG and POAG, or in single incision or separate incision in such combined surgery. LA: Chinese
Dr. Y. Cai, Peking University first hospital, Beijing 100034, China. cai_yuu@hotmail.com
Classification:
12.14.3 Phacoemulsification (Part of: 12 Surgical treatment > 12.14 Combined cataract extraction and glaucoma surgery)
