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Abstract #22509 Published in IGR 11-1
Early results of modified nonpenetrating deep sclerectomy and phacoemulsification in the treatment of open angle glaucoma and cataract
Yuen NSEuropean Journal of Ophthalmology 2009; 19: 72-79
PURPOSE: To study the outcome and control of intraocular pressure (IOP) of a combined modified nonpenetrating deep sclerectomy (NPDS) without use of implants and phacoemulsification in patients with primary open angle glaucoma (POAG) and cataract. METHODS: Prospective series of 14 eyes in 14 patients with medically uncontrolled POAG and cataract with significant visual impairment undergoing a modified NPDS and phacoemulsification. The surgery was designed to utilize all four mechanisms of outflow track of aqueous of NPDS without the use of scleral implant and a standardized postoperative management and early Nd:YAG laser goniopuncture at 4 weeks. All patients underwent clinical assessment before and after surgery at day 1, day 7, weeks 2, 3, and 4, and then at 2, 3, and 6 months postoperation. Surgical outcome was assessed in terms of IOP, visual acuity, and the incidence of complications. RESULTS: IOP decreased significantly from a preoperative value of 21.71±3.81 mmHg (mean ± SD) to a postoperative value of 13.14±3.73 mmHg (mean ± SD) (p<0.05, paired t test) at 6 months. The number of antiglaucoma eyedrops needed for control of IOP decreased from 3.28±0.91 to zero after operation at 6 months follow-up. The change in IOP pre and post laser goniopuncture was noted with no complication or fluctuation in anterior chamber depth. Visual acuity ranged from finger counting to 6/18 with Snellen chart at 6 meters preoperatively to 6/36 to 6/9 postoperatively. There were no intraoperative complications. There was one recessed conjunctival wound at 1 week. No other postoperative complication was noted. CONCLUSIONS: Modified NPDS without scleral implant with early Nd:YAG laser goniopuncture and phacoemulsification for treatment of patients with POAG and cataract is a safe and effective procedure with complete success at 6 months.
Dr. N.S. Yuen, Department of Ophthalmology, Tung Wah Eastern Hospital, Hong Kong - China
Classification:
12.8.3 Non-perforating (Part of: 12 Surgical treatment > 12.8 Filtering surgery)
12.14.3 Phacoemulsification (Part of: 12 Surgical treatment > 12.14 Combined cataract extraction and glaucoma surgery)
