New superior modified fornix-based twin-site phacotrabeculectomy

Area of Science:

• Ophthalmology
• Surgical Innovation

Background:

• Phacotrabeculectomy is the standard surgical approach for patients with both cataracts and glaucoma.
• Existing techniques may have limitations in managing these coexisting conditions.

Purpose of the Study:

• To introduce and evaluate a novel modified fornix-based, separate-site phacotrabeculectomy technique.
• To assess the efficacy and safety of this "twin-site" approach in patients with open-angle and angle-closure glaucoma.

Main Methods:

• A modified fornix-based, separate-site phacotrabeculectomy technique was developed.
• Mitomycin C (MMC) was applied during the procedure.
• The technique involved superiorly placed, side-by-side phacoemulsification and trabeculectomy.
• Surgical outcomes were evaluated in 130 eyes of 117 patients.

Main Results:

• The twin-site technique was performed safely and effectively, sparing limbal stem cells.
• The procedure demonstrated compatibility with mitomycin C (MMC) and a low incidence of wound leakage.
• No adverse effects on bleb survival were observed.
• Intermediate-term success rates were 79.2% complete success and 93.1% total success.
• Surgical time was comparable to one-site procedures.

Conclusions:

• The modified twin-site phacotrabeculectomy is a safe and efficacious surgical option for coexisting cataracts and glaucoma.
• This technique offers advantages including limbal stem cell sparing and good visual outcomes.
• The procedure achieves high success rates with manageable complications.