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BACKGROUND: During the last few years combined cataract and glaucoma surgery has become an established method to control intraocular pressure (IOP) and visual rehabilitation in patients with cataract and glaucoma. Despite this, there are currently few data concerning the results of combined surgery for primary open-angle glaucoma (POAG) and pseudoexfoliation glaucoma (PEXG). PATIENTS AND METHODS: To study the course of PEXG and POAG with respect to IOP regulation and visual acuity, 100 eyes with POAG (72 patients) and 22 with PEXG (19 patients) were evaluated, which underwent combined phacoemulsification and goniotrephination between 1993 and 1997. No patients had had either earlier glaucoma or other ocular surgery. The mean follow-up after operation was 39.5 (range, 16-72) months. RESULTS: The mean preoperative IOP in the PEXG (31.8 ± 10.3 mmHg) was significantly higher than in the POAG (25.3 >PLM> 6.4 mmHg) group (p = 0.0004). At follow-up, IOP had decreased to 16.7 ± 2.8 mmHg (POAG) and 15.1 ± 4.0 mmHg (PEXG (p < 0.0001). The absolute IOP lowering effect was significantly in PEXG than in POAG (p = 0.0003). All patients received medical treatment before surgery, whereas at follow-up 59.0% PEXG and 81.8% POAG were untreated. The median preoperative visual acuity for POAG was 0.32 (PEXG, 0.25) and visual outcome 0.63 (PEXG, 0.5). CONCLUSIONS: Combined cataract and glaucoma surgery is a successful method for IOP control and visual rehabilitation. It seems that there is a tendency for better efficiency and untreated IOP regulation after surgery for PEXG. Therefore, early surgical intervention could be an advantage in this glaucoma entity.LA: German
Dr A.H. Heuring, Universitätsaugenklinik Magdeburg, Leipzigerstrasse 44, D-39120 Magdeburg, Germany. Alexander.-Heuning@t-online.de
9.4.4.1 Exfoliation syndrome (Part of: 9 Clinical forms of glaucomas > 9.4 Glaucomas associated with other ocular and systemic disorders > 9.4.4 Glaucomas associated with disorders of the lens)
12.14.3 Phacoemulsification (Part of: 12 Surgical treatment > 12.14 Combined cataract extraction and glaucoma surgery)