Phacotrabeculectomy with or without punch: preliminary results comparing the two techniques

Area of Science:

• Ophthalmology
• Surgical Innovation

Background:

• Cataract and open-angle glaucoma often coexist, necessitating combined surgical approaches.
• Traditional combined surgeries can be lengthy and technically demanding.

Purpose of the Study:

• To evaluate the efficacy and safety of a novel surgical technique for combined glaucoma and cataract surgery.
• To compare the outcomes of phacoemulsification with Cairns trabeculectomy versus phacoemulsification with Crozafon-De Laage punch filtering surgery.

Main Methods:

• A prospective study involving 24 patients with open-angle glaucoma and cataracts.
• Group 1 (n=12): Phacoemulsification with Cairns trabeculectomy.
• Group 2 (n=12): Phacoemulsification with Crozafon-De Laage punch protective filtering surgery.

Main Results:

• The Crozafon-De Laage punch facilitated easier creation of a filtering fistula through the phacoemulsification sclerocorneal tunnel.
• Combined surgery using the punch demonstrated a shorter overall surgical duration compared to the Cairns method.
• A notable disadvantage of the punch was a reduced filtering gradability relative to Cairns trabeculectomy.

Conclusions:

• The Crozafon-De Laage punch presents a user-friendly alternative for combined glaucoma and cataract surgery, potentially reducing operative time.
• While advantageous in ease of use, the punch's efficacy in achieving adequate filtration may be less than conventional trabeculectomy.
• Further research is warranted to optimize punch technique and assess long-term filtration outcomes.