The contribution of phacoemulsification to combined cataract and glaucoma surgery

Current Opinion in Ophthalmology

Volumn 9, Issue 2, 1998, Pages 95-100

  El Sayyad, Fathi ^a   El Maghraby, Akef ^a  

^a El Maghraby Eye Hospital   (Saudi Arabia)

Author keywords

[No Author keywords available]

Indexed keywords

ASTIGMATISM; BLEEDING; CATARACT; CATARACT EXTRACTION; CONJUNCTIVA; FILTERING OPERATION; GLAUCOMA; GLAUCOMA SURGERY; HUMAN; INCISION; INFLAMMATION; INTRAOCULAR PRESSURE; LENS IMPLANT; PHACOEMULSIFICATION; PRIORITY JOURNAL; REVIEW; SCAR FORMATION; SCLERA; SURGICAL TECHNIQUE;

EID: 0031749510     PISSN: 10408738     EISSN: None     Source Type: Journal    
DOI: 10.1097/00055735-199804000-00017     Document Type: Review

References (26)

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4. Naveh N, Kottass R, Glovinsky J, et al.: The long-term effect on intraocular pressure of a procedure combining trabeculectomy and cataract surgery as compared with trabeculectomy alone. Ophthalmic Surg Lasers 1990, 21:339-345.
5. Tezel G, Kolker AE, Kass MA, Waz MB: Comparative results of combined procedures for glaucoma and cataract: I. Extracapsular cataract extraction versus phacoemulsification and foldable versus rigid intraocular lenses. Ophthalmic Surg Lasers 1997, 28:539-550. The authors retrospectively reviewed the results of combined extracapsular cataract extraction and rigid intraocular lens (IOL) implantation with trabeculectomy and compared it with combined phacotrabeculectomy and foldable IOL implantation. Releasable scleral flap sutures were used in all surgeries. This study showed the increased efficacy and safety of combined phacotrabeculectomy with a foldable IOL when compared to the extracapsular technique.
6. Yamagami S, Hamada N, Araie M, Shirato S: Risk factors for unsatisfactory intraocular pressure controls in combined trabeculectomy and cataract surgery. Ophthalmic Surg Lasers 1997, 28:476-482. This paper retrospectively analyzes the results seen in 60 eyes that underwent combined extracapsular cataract extraction (ECCE) and rigid posterior chamber IOL implantation or combined phacotrabeculectomy with foldable or rigid IOLs. The authors postulate that ECCE is a significant risk factor for late IOP control and conclude that the phacoemulsification technique and not ECCE should be employed in combined trabeculectomy and posterior chamber IOL implantation.
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13. Cohen JS, Greff LJ, Novack GD, Wind BE: A placebo-controlled, double-masked evaluation of mitomycin C in combined glaucoma and cataract procedures. Ophthalmology 1996, 103:1934-1942. This randomized study recommends the use of 2.5-minute, subconjunctival mitomycin C (0.5 mg/mL) in combined phacoemulsification. IOL implantation, and trabeculectomy with releasable sutures as it increases the success of glaucoma procedures with relatively minor toxicity. An alternative releasable suture technique is described. However, the suture free end in this technique can cause irritation and mucous collection with potential infection.
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18. Stewart WC, Sine CS, Carlson AN: Three-millimeter versus 6-mm incisions in combined phacoemulsification and trabeculectomy. Ophthalmic Surg Lasers 1996, 27:832-838. The authors evaluated the effect of a 6-mm incision in phacotrabeculectomy and compared it to small incision (3 mm). Similar postoperative IOP control and visual acuity were obtained in both groups. These results suggest that if a foldable lens is unavailable, combined phacotrabeculectomy with rigid lens through a 6-mm incision is still recommended to achieve better long-term IOP control and visual results.
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20. Wedrich A, Menapace R, Radax U, Papapanos P: Long term results of combined trabeculectomy and small incision cataract surgery. J Cataract Refract Sur 1995, 21:49-54.
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23. Samuelson TW: Surgical management of coincident cataract and glaucoma. Curr Opin Ophthalmol 1997, 8:39-45. Thorough review of the literature from 1995 to 1996 as it pertains to the surgical management of coincident cataract and glaucoma. The author also gives his own vast experience in discussing all various techniques of combined procedures and describes his own preferred approach.
24. Weitzman M, Caprioli J: Temporal corneal phacoemulsification combined with separate-incision superior trabeculectomy. Ophthalmic Surg 1995, 26:271-273.
25. Park HJ, Weitzman M, Capnoli J: Temporal corneal phacoemulsification combined with superior trabeculectomy: a retrospective case-control study. J Arch Ophthalmol 1997, 115:318-323. The authors conducted a retrospective case-control study where they matched 40 consecutive patients who underwent temporal corneal phacoemulsification combined with superior trabeculectomy and 40 control-matched patients who underwent trabeculectomy alone. They found that combined surgery provides less long-term IOP reduction compared with trabeculectomy alone. It will be interesting to know the behavior of IOP reduction in trabeculectomy group following phacoemulsification, should those patients need cataract surgery.
26. Stewart WC, Crinkley CMC, Carlson AN: Results of combined phacoemulsification and trabeculectomy in patients with elevated preoperative intraocular pressures. J Glaucoma 1995, 4:164-169.