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[Trabeculotomy Combined with Cataract Surgery in Glaucoma: Outcome in a Rural Setting].

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Summary

Trabeculotomy combined with cataract surgery effectively lowers intraocular pressure (IOP) and reduces medication needs in glaucoma patients. This combined procedure offers a safe and successful treatment option, even without intensive postoperative care.

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Area of Science:

  • Ophthalmology
  • Surgical Innovation

Background:

  • Intensive postoperative care is crucial for trabeculectomy outcomes.
  • Rural settings often present challenges for frequent patient follow-ups.
  • Alternative surgical approaches are needed for combined cataract and glaucoma cases.

Purpose of the Study:

  • To evaluate the efficacy of combined trabeculotomy and cataract surgery in glaucoma patients.
  • To assess the impact of this combined procedure on intraocular pressure (IOP) and medication use.
  • To determine the surgical success rate in a setting with limited postoperative care.

Main Methods:

  • Retrospective clinical study of 142 patients with glaucoma and cataract.
  • All patients underwent combined trabeculotomy and cataract surgery by a single surgeon.
  • Outcomes including IOP, medication use, and success rates were assessed at 2 months and long-term follow-up (≥1 year).

Main Results:

  • Significant reduction in IOP from 24.1 mmHg preoperatively to 15.1 mmHg at longest follow-up (p < 0.0001).
  • Mean number of antiglaucomatous medications decreased from 1.35 to 0.73 at longest follow-up.
  • Complete surgical success (IOP < 22 mmHg without medication) achieved in 51.3% of patients.

Conclusions:

  • Combined trabeculotomy and cataract surgery is a safe and effective treatment for coexisting glaucoma and cataract.
  • The procedure demonstrates good long-term IOP control and reduced medication dependency.
  • This approach is suitable for patients, particularly in settings where intensive postoperative care is not feasible.