Visual rehabilitation and intraocular pressure control after combined manual small incision cataract surgery and...

Both cataract and glaucoma are significant public health problems. Combined cataract operation and trabeculectomy is required for visual rehabilitation and control of intraocular pressure (IOP) thereby preventing progressive optic nerve damage, in patients with coexisting cataract and glaucoma. The aim of this study was to find out the visual rehabilitation and IOP control following combined manual small incision cataract surgery (SICS) and mitomycin-C (MMC) augmented trabeculectomy. In this study 45 consecutive eyes of 45 patients who had undergone combined procedures (manual SICS+ trabeculectomy with MMC) were reviewed between September 2011 and August 2012. Postoperative visual acuity and IOP were recorded at postoperative day 1, 2nd week and 6th week to see the short term outcome of surgery and any postoperative complications were recorded. Best corrected visual acuity (BCVA) at 6th week follow-up was noted. Out of 45 patients males were 31 (68.8%) and females were 14 (31.1%). Twenty nine (64.4%) patients were Primary open angle glaucoma (POAG), 11 (24.4%) Primary angle closure glaucoma (PACG), 5 (11.1%) Normal tension glaucoma (NTG) with visually significant cataract. The mean preoperative and postoperative IOP was 23.93 mmHg ± 0.75 mmHg and 11.2 mmHg ± 1.5 mmHg respectively. The mean reduction in IOP was 12.73 mmHg on the 6th week of follow up. There was statistically significant reduction in IOP on the 6th week follow up (p < 0.000 1). Twenty three patients (65.7%) achieved best corrected visual acuity between 6/6 to 6/18 and 6 patients (17.1%) had 6/24 to 6/60 on the 6th week follow up. Combined SICS with MMC augmented trabeculectomy is effective in terms of IOP control and visual rehabilitation in treating glaucoma patients with cataract.