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Abstract #6943 Published in IGR 4-1
Long-term results of cataract surgery combined with trabeculotomy
Hoffmann E; Schwenn O; Karallus M; Krummenauer F; Grehn F; Pfeiffer NGraefe's Archive for Clinical and Experimental Ophthalmology 2002; 240: 2-6
BACKGROUND: There are different surgical approaches for cataract and concomitant primary open-angle glaucoma (POAG). In a retrospective study, the authors examined the long-term results of cataract extraction combined with trabeculotomy. PATIENTS AND METHODS: Between 1990 and 1997, 194 eyes with cataract and POAG were operated on in a combined manner. Eighty-eight eyes received trabeculotomy (TT), in 82 eyes trabeculectomy was added to the trabeculotomy (TT+TE), and in 24 eyes, in which probing of Schlemm's canal was impossible, standard trabeculectomy (TE) was performed. Pre- and postoperative intraocular pressure (IOP), glaucoma medication, and the intra- and postoperative complications of all patients were analyzed. RESULTS: Hyphema was the most common complication in the TT group (20.5%). Fibrin reaction occurred in 27.8% of all cases. There was no statistically significant difference in postoperative IOP between the TT and the TT+TE groups. A statistically significant decrease in IOP compared to preoperatively lasted for 60 months in the TT group. In eyes with a preoperative IOP ≤20 mmHg, none of the three procedures reduced IOP significantly (<20% of the preoperative IOP). In the first two years after operation, 50% of the patients had no need of antiglaucomatous medication. CONCLUSIONS: Cataract surgery combined with TT resulted in few complications. In low-tension glaucoma, the combination with TT is not sufficient to decrease the IOP. However, in patients with higher preoperative IOP, cataract surgery combined with TT could be - on the basis of a postoperative observations time of 72 months - a suitable method for lowering the IOP sufficiently. Furthermore, the use of antiglaucomatous substances was reduced by this combined procedure.
Dr. E. Hoffmann, Department of Ophthalmology, Johannes Gutenberg University of Mainz, Langenbeckstrasse 1, 55131 Mainz, Germany. hoffmann@augen.klinik.uni-mainz.de
Classification:
12.14.3 Phacoemulsification (Part of: 12 Surgical treatment > 12.14 Combined cataract extraction and glaucoma surgery)
