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Abstract #8018 Published in IGR 4-3
Two-site phacotrabeculectomy with intraoperative mitomycin-C: fornix- versus limbus-based conjunctival opening in fellow eyes
Kozobolis VP; Siganos CS; Christodoulakis EV; Lazarov NP; Koutentaki MG; Pallikaris IGJournal of Cataract and Refractive Surgery 2002; 28: 1758-1763
PURPOSE: To prospectively compare the influence of fornix- and limbus-based conjunctival flaps on the final outcome and complications of two-site phacotrabeculectomy with mitomycin-C in fellow eyes of patients with bilateral open-angle glaucoma (OAG). METHODS: Twenty-two patients with bilateral primary OAG and eight with bilateral exfoliative glaucoma had two-site phacotrabeculectomy in both eyes. Eyes were randomly assigned to the fornix- or limbus-based flap groups by the use of random tables. RESULTS: The intraocular pressure (IOP) decreased significantly in both groups (p < 0.01); however, there was no statistically significant difference between the groups in the amount of IOP decrease or the number of postoperative antiglaucoma medications after a one-year follow-up. Faster improvement in visual acuity was observed in the fornix-based group during the first week. The mean time of surgery was three and a half minutes less in the fornix-based group. An increased incidence of fibrin exudation, pupillary membrane formation, and capsule opacification was found in eyes with exfoliative glaucoma. The early bleb leakage was three times more frequent in the fornix-based group. CONCLUSIONS: The type of conjunctival flap in a two-site phacotrabeculectomy did not seem to influence the final outcome. The main advantage of the fornix-based conjunctival flap is the shorter surgical time and the relatively faster improvement in vision postoperatively. The main disadvantage is more frequent early bleb leakage.
V.P. Kozobolis, MD, Glaucoma Unit, Department of Ophthalmology, University of Crete, Crete, Greece
Classification:
12.14.3 Phacoemulsification (Part of: 12 Surgical treatment > 12.14 Combined cataract extraction and glaucoma surgery)
