[The value of "Crozafon-De Laage punch" in combined phacoemulsification--trabeculectomy]

To assess the efficacy and safety of the "Crozafon-De Laage punch" during combined phacoemulsification-trabeculectomy interventions.

We conducted a retrospective Study of 75 eyes of 75 patients with cataract and open-angle glaucoma inadequately controlled by maximum medical and/or physical treatment. They underwent phacotrabeculectomy using the Crozafon-De Laage punch. We noted pre- and postoperative best visual acuity (VA) and intraocular pressure (IOP) as well as intra- and postoperative complications.

After a mean follow-up of 24 months (range, 9-36), the functional results were satisfactory, with an average VA gain during the 1(st) postsurgical month of 5.8/10(e)+/-1.58 (compared to the preoperative VA). This gain in VA was steady with VA greater than 5/10(e) in 96% of our patients at 1 and 24 postoperative months. The mean IOP reduction was meaningful and steady: reduction of 8.2mm at the 9(th) postoperative month maintained to the 24(th) month. Ninety-five percent of our patients did not need medical treatment until the last follow-up; for the remaining 5%, IOP was controlled using a single agent. No intraoperative complications related to the use of the Crozafon-De Laage punch were noted. The postoperative complications were marked by the occurrence of a minimal and transient inflammatory reaction in 5.3% of cases; it was associated with a pseudoexfoliative syndrome in all cases.

Phacotrabeculectomy using the Crozafon-De Laage punch provides better control of glaucoma, faster functional rehabilitation, and fewer complications associated with filtration surgery.