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Abstract #71485 Published in IGR 18-3
Success rates of 2-site phacoemulsification combined with fornix-based trabeculectomy using mitomycin C for primary angle-closure glaucoma and primary open-angle glaucoma in an Asian population
Koh V; Chen D; Aquino CM; Aduan J; Sng C; Chee LS; Chew PJapanese Journal of Ophthalmology 2017; 61: 245-252
PURPOSE: To determine the long-term outcomes of 2-site phacoemulsification combined with fornix-based trabeculectomy using mitomycin C (MMC) for primary angle-closure glaucoma (PACG) and primary open-angle glaucoma (POAG) in an Asian population. METHODS: We reviewed the records of all patients with POAG or PACG who underwent phacoemulsification with trabeculectomy using MMC from January 2008 through December 2010 in a tertiary ophthalmology unit in Singapore. The primary outcome measure was cumulative success rates defined as complete [intraocular pressure (IOP) <21, 18, 15 mmHg without medication] and qualified (IOP <21, 18, 15 mmHg with at least 1 medication) success. RESULTS: In total, 168 eyes (110 POAG and 58 PACG) were included (43.5% female; mean age ± SD, 68.3 ± 8.2 years). The respective 3-year qualified success rates were 88.4, 79.3, and 52.5% for IOP <21, 18, and 15 mmHg. The corresponding complete success rates were 79.0, 70.9, and 51.1%. The mean 3-year postoperative IOP was 14.5 ± 4.4 mmHg, and the IOP reduction was significantly greater for PACG than for POAG eyes (P = 0.006). After surgery, the mean number of medications was significantly reduced and visual acuity, significantly improved (both P < 0.001). Occurrence of postoperative complications, higher number of topical medications, younger age, and presence of diabetes mellitus were significant risk factors for surgical failure. CONCLUSION: Two-site phacoemulsification combined with fornix-based trabeculectomy using MMC is a good surgical approach for Asian eyes with concomitant mild-to-moderate primary glaucoma and cataracts.
Department of Ophthalmology, National University Health System, 1E Kent Ridge Road, Level 7, NUHS Tower Block, Singapore, 119228, Singapore. viktorkoh@gmail.com.
Full articleClassification:
12.14.3 Phacoemulsification (Part of: 12 Surgical treatment > 12.14 Combined cataract extraction and glaucoma surgery)
12.8.10 Woundhealing antifibrosis (Part of: 12 Surgical treatment > 12.8 Filtering surgery)
9.3.2 Chronic primary angle closure glaucoma (pupillary block) (Part of: 9 Clinical forms of glaucomas > 9.3 Primary angle closure glaucomas)