Comparison study of phacotrabeculectomy combined with or without peripheral iridectomy

Abstract

Objective To compare therapeutic effects of the phacotrabeculectomy and intraocular lens implantation with and without peripheral iridectomy(PI).Methods Retrospective analysis of 32 cases (38 eyes) glaucomatous patients with a coexisting cataract,patients randomized for PI in 20 eyes or no PI in 18 eyes during the combined two-site phacoemulsification,foldable intraocular lens implantatidn and trabeculectomy,The two groups were compared for visual acuity (VA),intraocular pressure ( IOP),complication rates,and parameters variation of anterior chamber pre-and postoperative with Pentacam.followed for 12months.Results There were no statistical differences in two groups for anterior chamber angle,central anterior chamber depth,superior peripheral chamber depth in preoperative,1 week,1 month,3 months,6months,12 months postoperatively (P ＞ 0.05).The mean postoperative IOP lower than preoperative in both groups in 12 months after surgery (P ＜ 0.05 ).There was no differences in two groups for mean postoperative introcular pressure in 12 months after surgery (t =0.04,P ＞ 0.05 ).1 week postoperatively,corrected visual acuity were better than 0.3 (89.5 ％ ) in 34 eyes,the number was 4 eyes (10.5％) preoperation.There was no statistical differences in two groups ( P ＞ 0.05 ).The postoperative early complicatirm was corneal edema and anterior chamber exudation,small amounts hyphema in one eye from the PI group,and one eye from the no PI group developed an iris incarceration into the internal sclerectomy site on postoperative day 1,returned to normal by peripheral iridectomy.No other significant complications.Conclusion Combined phacoemulsification,foldable intraocular lens implantation and trabeculectomy,peripheral iridectomy or no peripheral iridectomy were similiarly safe and effective in improve visual acuity,lower lOP,deepen anterior champber and less complication in patients with co-existing glaucoma and cataract. Key words: Phacoemulsification; Trabeculectomy; Glaucoma with cataract; Peripheral iridectomy; Pentacam system