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Laser trabeculoplasty and cataract surgery.

M A Galin, S A Obstbaum, Y Asano

    Transactions of the Ophthalmological Societies of the United Kingdom
    |January 1, 1985
    PubMed
    Summary

    Combined glaucoma surgery offers superior long-term intraocular pressure control compared to argon laser trabeculoplasty (ALT) followed by cataract surgery. This approach significantly improves outcomes for open-angle glaucoma patients.

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    Conquering capsule opacification.

    Journal of cataract and refractive surgery·2000

    Area of Science:

    • Ophthalmology
    • Glaucoma Management
    • Surgical Interventions

    Background:

    • Open-angle glaucoma, optic nerve damage, and visual field loss necessitate effective intraocular pressure (IOP) control.
    • Cataract development often co-exists with glaucoma, requiring simultaneous or sequential treatment.
    • Current treatment paradigms include surgical interventions and laser therapies, with varying long-term efficacy.

    Purpose of the Study:

    • To compare the long-term IOP control of different surgical strategies in patients with open-angle glaucoma and cataracts.
    • To evaluate the efficacy of combined trabeculectomy or sclerectomy with cataract extraction versus argon laser trabeculoplasty (ALT) followed by lens extraction.

    Main Methods:

    • A comparative study involving three patient groups: trabeculectomy with cataract extraction (108 patients), guarded posterior lip sclerectomy with cataract extraction and implantation (28 patients), and ALT followed by lens extraction and implantation (27 patients).
    • Intraocular pressure (IOP) levels were monitored post-operatively, with and without topical medication.
    • Assessment of visual field loss and optic nerve head status was conducted.

    Main Results:

    • Approximately 75% of patients achieved an IOP of ≤18 mm Hg without medication after trabeculectomy with cataract extraction.
    • Around 40% of patients achieved similar IOP control without medication after guarded posterior lip sclerectomy with cataract extraction and implantation.
    • Only about 25% of patients achieved IOP ≤18 mm Hg on medication after ALT, with none achieving control without medication. Cataract surgery post-ALT led to loss of IOP control in some patients.

    Conclusions:

    • Combined surgical procedures, including trabeculectomy or sclerectomy with cataract extraction (with or without lens implantation), provide superior and more sustained IOP control for open-angle glaucoma patients compared to ALT followed by lens extraction.
    • These findings suggest that combined surgery is a more effective strategy for managing co-existing glaucoma and cataracts, potentially reducing the need for long-term medical management.

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