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Lens capsule inclusion in trabeculectomy with cataract extraction
M Anwar1, F el-Sayyad, A el-Maghraby
1Department of Ophthalmology, El-Maghraby Eye Hospital, Jeddah, Saudi Arabia.
Journal of Cataract and Refractive Surgery
|November 14, 1997
Summary
This study explored using the anterior lens capsule in trabeculectomy surgery to improve glaucoma filtration. The combined procedure successfully reduced intraocular pressure and enhanced visual acuity in patients with cataracts and glaucoma.
Area of Science:
- Ophthalmology
- Glaucoma Surgery
- Cataract Surgery
Background:
- Glaucoma and cataracts often coexist, requiring combined surgical intervention.
- Uncontrolled intraocular pressure (IOP) in glaucoma necessitates effective filtration strategies.
Purpose of the Study:
- To evaluate the efficacy of incorporating the anterior lens capsule into the trabeculectomy site.
- To determine if this technique enhances filtration in glaucoma blebs.
Main Methods:
- A combined trabeculectomy, extracapsular cataract extraction, and intraocular lens implantation was performed.
- The anterior lens capsule was deliberately included under the trabeculectomy scleral flap in 25 eyes of 23 patients.
- Follow-up ranged from 6 to 72 months.
Main Results:
- Improved visual acuity was observed in all eyes post-cataract extraction.
- 80% of eyes achieved a postoperative intraocular pressure (IOP) of 20 mm Hg or less.
- A diffuse filtration bleb was successfully created in most cases, suggesting effective filtration.
Conclusions:
- The combined surgical approach offers visual rehabilitation and effective IOP control for patients with cataracts and glaucoma.
- The anterior lens capsule, used as a 'capsular wick,' appears to aid in maintaining filtration after trabeculectomy.