Early results of modified nonpenetrating deep sclerectomy and phacoemulsification in the treatment of open angle glaucoma and cataract.
| Autor: | Yuen NS; Department of Ophthalmology, Tung Wah Eastern Hospital, Hong Kong, China. nyuensy@yahoo.com |
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| Jazyk: | angličtina |
| Zdroj: | European journal of ophthalmology [Eur J Ophthalmol] 2009 Jan-Feb; Vol. 19 (1), pp. 72-9. |
| DOI: | 10.1177/112067210901900111 |
| Abstrakt: | Purpose: To study the outcome and control of intraocular pressure (IOP) of a combined modified nonpenetrating deep sclerectomy (NPDS) without use of implants and phacoemulsification in patients with primary open angle glaucoma (POAG) and cataract. Methods: Prospective series of 14 eyes in 14 patients with medically uncontrolled POAG and cataract with significant visual impairment undergoing a modified NPDS and phacoemulsification. The surgery was designed to utilize all four mechanisms of outflow track of aqueous of NPDS without the use of scleral implant and a standardized postoperative management and early Nd:YAG laser goniopuncture at 4 weeks. All patients underwent clinical assessment before and after surgery at day 1, day 7, weeks 2, 3, and 4, and then at 2, 3, and 6 months postoperation. Surgical outcome was assessed in terms of IOP, visual acuity, and the incidence of complications. Results: IOP decreased significantly from a preoperative value of 21.71+/-3.81 mmHg (mean +/- SD) to a postoperative value of 13.14+/-3.73 mmHg (mean +/- SD) (p<0.05, paired t test) at 6 months. The number of antiglaucoma eyedrops needed for control of IOP decreased from 3.28+/-0.91 to zero after operation at 6 months follow-up. The change in IOP pre and post laser goniopuncture was noted with no complication or fluctuation in anterior chamber depth. Visual acuity ranged from finger counting to 6/18 with Snellen chart at 6 meters preoperatively to 6/36 to 6/9 postoperatively. There were no intraoperative complications. There was one recessed conjunctival wound at 1 week. No other postoperative complication was noted. Conclusions: Modified NPDS without scleral implant with early Nd:YAG laser goniopuncture and phacoemulsification for treatment of patients with POAG and cataract is a safe and effective procedure with complete success at 6 months. |
| Databáze: | MEDLINE |
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