Extracapsular lens extraction and posterior chamber intraocular lens insertion combined with trabeculectomy

Trabeculectomy for primary glaucoma was successfully combined with extracapsular lens extraction and insertion of a Pearce tripod posterior chamber lens in seven eyes of five patients. The results were similar to those expected from each component of the operation when performed alone, and all eyes achieved visual acuity of 6/9 or better with control of intraocular pressure below 22 mmHg without supplementary medical treatment. The incidence of mild anterior uveitis (three out of seven eyes) and hyphaema (two out of seven eyes) was greater than usual with this type of cataract extraction but no more than expected after trabeculectomy. Mydriatic drops may be used to treat postoperative iritis without danger to the stability of this pattern of implant. In addition the anterior chamber cannot become shallow, as the rigid legs of this lens extend behind the iris beyond the periphery of the cornea and prevent forward movement of the implant even if there is excessively free drainage of aqueous after the operation.