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Related Experiment Videos

Combined phacoemulsification and trabeculectomy with mitomycin-C

J M Ruderman1, B Fundingsland, M A Meyer

  • 1Department of Ophthalmology, North-western University Medical School, Chicago, Illinois 60611-1210, USA.

Journal of Cataract and Refractive Surgery
|October 1, 1996
PubMed
Summary
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Combined phacoemulsification, intraocular lens implantation, and trabeculectomy with mitomycin-C safely reduced intraocular pressure and improved vision in glaucoma patients. Mitomycin-C did not appear to significantly enhance outcomes in this combined procedure.

Area of Science:

  • Ophthalmology
  • Glaucoma Research
  • Surgical Innovation

Background:

  • Cataracts and open-angle glaucoma often coexist, necessitating combined surgical approaches.
  • Effective intraocular pressure (IOP) management is crucial for preventing glaucoma progression.
  • Phacoemulsification with intraocular lens (IOL) implantation is a standard cataract surgery technique.

Purpose of the Study:

  • To evaluate the safety and efficacy of primary combined phacoemulsification, posterior chamber IOL implantation, and trabeculectomy with mitomycin-C.
  • To assess visual acuity outcomes and IOP control in patients with open-angle glaucoma and cataracts.
  • To identify potential complications associated with this combined surgical procedure.

Main Methods:

  • Retrospective analysis of 43 consecutive patients undergoing combined surgery by a single surgeon.

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  • Inclusion of patients with open-angle or pseudoexfoliative glaucoma and visually significant cataracts.
  • Follow-up duration of at least 6 months, with 88% of patients observed for 12 months.

    • Main Results:

    • Mean preoperative IOP of 21.6 mm Hg decreased to 14.2 mm Hg at last follow-up, with a reduction in glaucoma medications.
    • 55% of patients achieved an IOP of 15 mm Hg or less at 12 months.
    • Good visual acuity (20/40 or better) was achieved in 72% of patients; however, complications such as IOP spikes, hyphema, and wound leaks were observed.

    Conclusions:

    • Combined phacoemulsification, IOL implantation, and trabeculectomy with mitomycin-C can yield good visual acuity and effective IOP control.
    • The addition of mitomycin-C to this combined procedure did not demonstrate a significant additional benefit.
    • While effective, the procedure is associated with a notable rate of complications requiring careful patient monitoring.