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Combined surgery for cataract and glaucoma: phacoemulsification and deep sclerectomy compared with
F Gianoli1, C C Schnyder, E Bovey
1Hôpital Ophtalmique Jules Gonin, University of Lausanne, Switzerland.
Journal of Cataract and Refractive Surgery
|March 18, 1999
Summary
Phacoemulsification with nonperforating deep sclerectomy offers similar intraocular pressure reduction and visual outcomes to phacotrabeculectomy. This approach results in fewer complications, facilitating easier ambulatory care for glaucoma patients.
Area of Science:
- Ophthalmology
- Glaucoma Surgery
- Cataract Surgery
Background:
- Cataract and open-angle glaucoma often coexist, requiring combined surgical approaches.
- Phacoemulsification with intraocular lens (IOL) implantation is a standard cataract surgery.
- Trabeculectomy is a common glaucoma surgical procedure.
Purpose of the Study:
- To compare the efficacy and safety of phacoemulsification-IOL implantation combined with nonperforating deep sclerectomy (P-DS) versus phacoemulsification-IOL implantation combined with trabeculectomy (P-T).
Main Methods:
- A prospective study involving 60 eyes of 60 patients with cataract and open-angle glaucoma.
- Thirty eyes underwent P-DS, and 30 eyes underwent P-T.
- Follow-up was conducted for up to 18 months.
Main Results:
- Both P-DS and P-T groups showed similar reductions in intraocular pressure (IOP) and comparable visual outcomes.
- The P-DS group experienced significantly less postoperative inflammation (40.0% vs. 83.0%) and hyphema (6.7% vs. 36.7%) compared to the P-T group.
- Mean follow-up was approximately 12.5 months for both groups.
Conclusions:
- Nonperforating deep sclerectomy combined with cataract surgery provides similar IOP reduction and visual outcomes to phacotrabeculectomy.
- P-DS demonstrates a lower complication rate, enhancing suitability for ambulatory care.
- This suggests P-DS is a viable alternative to P-T for combined cataract and glaucoma surgery.