Modified small-incision cataract surgery for combined extraction - A comparative study of two techniques

Area of Science:

• Ophthalmology
• Surgical Techniques
• Glaucoma Management

Background:

• Cataract surgery with coexisting primary glaucoma requires effective intraocular pressure (IOP) management.
• Small-incision cataract surgery (SICS) combined with trabeculectomy is a common approach.
• Evaluating different incision techniques is crucial for optimizing surgical outcomes.

Purpose of the Study:

• To compare the efficacy of a straight incision technique versus a modified "frown" incision with a triangular scleral flap in small-incision cataract surgery (SICS) with trabeculectomy for IOP reduction.
• To assess the long-term IOP-lowering capacity of these two surgical approaches.

Main Methods:

• A comparative study involving 44 eyes with cataract and primary glaucoma at a tertiary health center.
• Patients underwent SICS with trabeculectomy using either a modified "frown" incision (Group A, n=22) or a straight incision (Group B, n=22).
• Postoperative evaluations were conducted at multiple intervals up to 6 months, with data analyzed using statistical software.

Main Results:

• Mean preoperative IOP was significantly higher in Group A (38.6 mm Hg) compared to Group B (29.1 mm Hg).
• After 6 months, both techniques demonstrated comparable IOP reduction, with mean differences of 20.8 mm Hg (Group A) and 17.2 mm Hg (Group B).
• The capacity of IOP reduction was similar between the two groups up to 6 months post-surgery.

Conclusions:

• The straight incision technique and the modified "frown" incision with a triangular scleral flap offer comparable IOP-lowering efficacy in SICS with trabeculectomy.
• The modified "frown" incision technique requires greater surgical expertise.
• The simpler straight incision technique is a viable and effective option for ophthalmologists, particularly for managing combined cataract and glaucoma cases.