Combined phacoemulsification and filtering surgery with the 'no-stitch' technique

Area of Science:

• Ophthalmology
• Glaucoma Surgery
• Cataract Surgery

Background:

• Advanced chronic open-angle glaucoma requires effective intraocular pressure (IOP) management.
• Combined procedures aim to address both glaucoma and cataracts simultaneously.
• The efficacy of specific surgical modifications in lowering IOP is under investigation.

Purpose of the Study:

• To evaluate if a radial incision during combined filtering surgery leads to a sustained reduction in intraocular pressure (IOP).
• To assess the impact of this surgical technique on the development of filtering blebs.
• To compare the IOP-lowering effect with cataract surgery alone.

Main Methods:

• A prospective study comparing 43 eyes undergoing combined filtering surgery with a radial incision to 42 control eyes receiving cataract surgery alone (phacoemulsification).
• The study group had the tunnel floor transected with Vannas scissors during the combined procedure.
• Patients in both groups had advanced chronic open-angle glaucoma.

Main Results:

• One year post-surgery, the study group experienced a statistically significant mean IOP decrease of 7.6 mm Hg compared to 3.7 mm Hg in the control group (P<.001).
• The combined surgery group required an average of 1.5 fewer medications, while the control group needed 0.5 fewer medications.
• The radial incision technique demonstrated a superior IOP-lowering effect.

Conclusions:

• The combined surgical procedure incorporating a radial incision effectively achieves a lasting reduction in intraocular pressure.
• While cataract surgery alone also reduced IOP, the effect was significantly less pronounced than the combined approach.
• This technique offers a promising option for managing glaucoma and cataracts concurrently.