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Abstract #15613 Published in IGR 1-3
Phacotrabeculectomy without peripheral iridectomy
Manners TD; Mireskandari KOphthalmic Surgery and Lasers 1999; 30: 631-635
BACKGROUND AND OBJECTIVE: Peripheral iridectomy has been a long established part of glaucoma drainage surgery. This series examines the potential to dispense with iridectomy when trabeculectomy is combined with modern small-incision cataract surgery. PATIENTS AND METHODS: Twenty-five unselected consecutive patients underwent a standardized phacotrabeculectomy by a single surgeon. Outcome measures included visual acuity, intraocular pressure control, and complication rates. Mean follow-up was 12.2 months. RESULTS: There were no complications related to lack of peripheral iridectomy. Intraocular pressure was reduced from a mean of 23.4 mmHg (SD 5.1) to 15.9 (SD 3.8) at six months, and 15.4 (SD 3.5) at 12.2 months. There were two relative failures of surgery, whose IOP reached preoperative targets with additional medical treatment. Best Snellen acuity improved by a mean of 1.5 lines. CONCLUSIONS: Phacotrabeculectomy without peripheral iridectomy appears to be safe, although the authors consider that a corneal fistula and careful control of postoperative overdrainage is necessary to allow this. The success rate and lack of complications is good by comparison with other series. This could be related to the absence of release of factors influencing healing at the time of an iridectomy.
Dr. T.D. Manners, Department of Ophthalmology, West Norwich Hospital, Norwich; UK
Classification:
12.14.3 Phacoemulsification (Part of: 12 Surgical treatment > 12.14 Combined cataract extraction and glaucoma surgery)
