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Abstract #19229 Published in IGR 3-1
Phacotrabeculectomy with mitomycin C for cataract and glaucoma
Teng M-C; Wu P-C; Lai I-C; Tsai J-C; Lin P-WJournal of Medical Ultrasound 2000; 8: 154-160
OBJECTIVE: To retrospectively study the effectiveness of combined one-site phacoemulsification, posterior-chamber intraocular lens (IOL) implantation, and trabeculectomy with mitomycin C soaking in patients with cataract and glaucoma. MATERIAL AND METHODS: The authors followed 57 eyes of 56 patients (mean age, 68.6 ± 8.2 years; 25 male and 31 female) for at least three months. All the patients' eyes had cataract and glaucoma (primary angle-closure glaucoma, 40 eyes; primary open-angle glaucoma, 16 eyes; angle-recession glaucoma, one eye). A fornix-based conjunctival flap with scleral tunnel procedure was performed on all the patients. The scleral tunnel and subtenon space were soaked with mitomycin C 0.2 mg/ml for 1.5 minutes, followed by a standard phacoemulsification procedure with posterior chamber IOL implantation and trabeculectomy. The scleral wound was sealed with or without sutures. RESULTS: The mean preoperative intraocular pressure (IOP) with therapy was 15.8 ± 6.26 mmHg (range, 7-35 mmHg) and had decreased to 9.08 ± 3.49 mmHg (range, 1-17) by the last postoperative follow-up. The mean number of glaucoma medications decreased from 1.75 ± 0.68 to 0.09 ± 0.29. Most of the complications were transient: 12 eyes (21%) had hyphema; seven eyes (12%) had a shallow anterior chamber; four eyes (7%) had ocular hypertension; one eye (2%) had conjunctival leakage; one eye (2%) had persistent keratitis; five eyes (9%) had hypotony; and three eyes (5%) developed hypotonic maculopathy. Log mean angle resolvable visual acuity (log MAR) scale increased from 0.84 ± 0.41 to 0.43 ± 0.38. CONCLUSIONS: Phacotrabeculectomy with mitomycin C is a safe, effective and relatively simple surgery for cataract patients with glaucoma.
Dr M.-C. Teng, Department of Ophthalmology, Chang-Gung Memorial Hospital, 123 Ta-Pei Road, Niao-Sung Hsiang, Kaohsiung Hsien, Taiwan
Classification:
12.14.3 Phacoemulsification (Part of: 12 Surgical treatment > 12.14 Combined cataract extraction and glaucoma surgery)