Comparision between modified phacotrabeculectomyand routine phacotrabeculectomyinangle close glaucoma with cataract

Abstract

Objective To compare the feasibility,effective and security ofphacotrabeculectomy with the resection of triangular deep scleral bed to routine phacotrabeculectomy in treatment of the advanced angle-closure glaucoma and coexisting cataract.Methods Clinical retrospective study.136 patients(142 eyes) of advanced angle-closure glaucoma with cataract were analyzed.86 eyes (modified group) were treated with modified phacotrabeculectomy with the resection of triangular deep scleral bed and 56 eyes were treated with routine phacotrabeculectomy(control group).The visual acuity,intraocular pressure(IOP),type of filtering bleb and postoperative complications were blind method observed after operation.Results The patients were followed up for 6 to 18 months(average 12±1.5 months).Both groups were performed the operation safely.Best corrected visual acuity were increased in both groups after surgery,there was no statistical difference between two groups(P ＞0.05).The IOP was no statistical difference (P ＞0.05) between the two groups before operation.The mean IOP and decreased IOP range were statistically significant (t =0.03,P ＜0.05)between two groups at 12 months post operation.Decreased IOP in the modified group was 16.5±4.9mmHg (ImmHg=0.133kPa)and decreased extent was 55.9％ compare to 11.5±5.1mmHg and 40.0％ in control.The functional filtering bleb(Ⅰ and Ⅱtype)in the modified groups was 73 eyes (84.9％),and 48 eyes(85.7％) in the control group,which was no significant difference(P ＞0.05).There was transient hypotony in two groups after operation.Conclusions The modified phacotrabeculectomy can reduce IOP more effectively than routinephacotrabeculectomy and induce no more postoperative complications.It is one of safe,effective and optional method in advanced angle-closure glaucoma with coexisting cataract patients. Key words: Angle closure glaucoma; Cataract; phacotrabeculectomy; Deep scleral resection