Combined phacoemulsification and trabeculectomy with mitomycin-C
| Autor: | Jon M. Ruderman, Brad Fundingsland, Marcus A. Meyer |
|---|---|
| Rok vydání: | 1996 |
| Předmět: |
medicine.medical_specialty
Intraocular pressure Visual acuity genetic structures Open angle glaucoma medicine.medical_treatment Mitomycin Visual Acuity Glaucoma Intraocular lens Trabeculectomy Postoperative Complications Ophthalmology medicine Humans Hyphema Intraocular Pressure Retrospective Studies Lenses Intraocular Antibiotics Antineoplastic Phacoemulsification business.industry medicine.disease Combined Modality Therapy eye diseases Sensory Systems Surgery Treatment Outcome sense organs medicine.symptom business Glaucoma Open-Angle Follow-Up Studies |
| Zdroj: | Journal of cataract and refractive surgery. 22(8) |
| ISSN: | 0886-3350 |
| Popis: | Purpose: To examine the safety and efficacy of primary combined phacoemulsification, posterior chamber intraocular lens (IOL) implantation, and trabeculectomy with mitomycin-C (0.4 mg/ml) in patients with open-angle glaucoma and visually significant cataract. Setting: University-hospital-based glaucoma referral practice. Methods: In this study, data of 43 patients of a single surgeon were retrospectively analyzed. These consecutive patients had combined phacoemulsification, posterior chamber IOL implantation, and trabeculectomy with mitomycin-C. Results: Thirty-eight patients (88%) had open-angle glaucoma and 5 (12%) pseudoexfoliative glaucoma. Thirty-eight patients (88%) had 12 months of follow-up; all had at least 6 months follow-up. Mean preoperative intraocular pressure (IOP) was 21.6 mm Hg ± 6.8 (SD) (range 12.0 to 41.0 mm Hg) with 2.5 ± 1.0 glaucoma medications. At last follow-up, mean IOP had decreased to 14.2 ± 6.2 mm Hg (range 3.0 to 40.0 mm Hg) with 0.5 ± 0.5 glaucoma medications. Twenty-one patients (55%) had an IOP of 15 mm Hg or less at 12 months. Best corrected visual acuity was 20/40 or better in 31 of 43 patients (72%) at last follow-up. A filtration bleb was noted in 33 of 40 patients (83%) at their last visit. Postoperative IOP spikes occurred in 17 patients (40%), transient hyphema in 12 (28%), transient wound leaks in 11 (26%), and superficial punctate keratopathy in 11 (26%). Three cases of persistent hypotony (IOP less than 5 mm Hg) and 1 case of epithelial downgrowth were also noted. Conclusion: Phacoemulsification with IOL implantation and combined trabeculectomy with mitomycin-C produced good visual acuity and excellent IOP control but resulted in some complications. The use of mitomycin-C in combined procedures does not appear to confer a significant benefit. |
| Databáze: | OpenAIRE |
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