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Abstract #6576 Published in IGR 3-2
Transscleral suture fixation of posterior chamber lenses combined with trabeculectomy
Shin DH; Birt CM; O'Grady JM; Kim C; Juzych MS; Lemon LC; Reed SY; Eliassi-Rad BOphthalmology 2001; 108: 919-929
OBJECTIVE: To evaluate the outcome of transscleral suture-fixated posterior chamber intraocular lens (PCIOL) implantation in glaucoma patients when combined with trabeculectomy. DESIGN: A retrospective study of 56 consecutive glaucoma patients with a minimum follow-up of six months after transscleral suture-fixated PCIOL implantation combined with trabeculectomy. PATIENTS: fifty-six eyes of 56 consecutive chronic glaucoma patients who had undergone transscleral suture-fixated PCIOL implantation in combination with trabeculectomy were included in the analysis. RESULTS: The mean follow-up time was 38.5 ± 19.1 months. Mean intraocular pressure (IOP) was significantly reduced, from 22.9 ± 10.9 mmHg before surgery to 16.7 ± 6.7 mmHg at the last follow-up visit (p = 0.0005), with the mean number of medications used also being significantly decreased, from 2.3 ± 0.9 to 1.9 ± 0.9 (p = 0.0002). Postoperative IOP control to 21 mmHg or less was achieved or maintained in 84% of patients. Visual acuity improved or remained stable within two Snellen lines of the preoperative level in 39 eyes (70%) and within three Snellen lines in 45 eyes (80%) at the last follow-up visit. Overall, 46-68% of patients had both stable visual acuity and satisfactory pressure control at the last postoperative visit, depending on criteria of varying stringency. However, 19 eyes (34%) required one or more additional surgical intervention for pressure control. Patients with anterior chamber intraocular lens (ACIOL) complications, diabetes mellitus, or a preoperative IOP level of more than 21 mmHg on maximum tolerated medications, were especially prone to requiring additional surgical interventions. CONCLUSIONS: The authors conclude that transscleral suture-fixated PCIOL implantation can be combined successfully with trabeculectomy and can be useful in glaucoma patients in need of both visual rehabilitation and IOP control. However, patients with ACIOL complications, diabetes, or a preoperative IOP of more than 21 mmHg on maximum tolerated medications, were prone to requiring additional surgical interventions.
Dr D.H. Shin, Kresge Eye Institute, Wayne State University School of Medicine, 4717 St Antoine Boulevard, Detroit, MI 48201-1423, USA. dongshin@med.wayne.edu
Classification:
12.14.1 Intracapsular (Part of: 12 Surgical treatment > 12.14 Combined cataract extraction and glaucoma surgery)
