Modified 360-degree suture trabeculotomy combined with phacoemulsification and intraocular lens implantation for glaucoma and coexisting cataract

Abstract

To assess the efficacy and safety of a modified 360-degree suture trabeculotomy combined with a cataract surgery technique in patients with glaucoma and coexisting cataract. Hokkaido University Hospital, Sapporo, Japan. Retrospective case series. Medical records of patients with glaucoma having a modified 360-degree trabeculotomy combined with cataract surgery (Group 1) were reviewed. Another group of patients who had the modified 360-degree suture trabeculotomy alone served as controls (Group 2). Both groups comprised 46 patients. In each group, eyes were diagnosed with primary angle-closure glaucoma in 2 eyes, primary open-angle glaucoma in 24 eyes, exfoliation glaucoma in 4 eyes, uveitic glaucoma in 15 eyes, and steroid glaucoma in 1 eye. The mean preoperative intraocular pressure (IOP) values were 27.2mm Hg±7.3 (SD) on 3.0±0.5 medications in Group 1 and 27.7±10.7mm Hg on 2.9±0.6 medications in Group 2. Twelve months after surgery, the mean IOPs were 13.4±3.7mm Hg on 0.8±1.1 medications in Group 1 and 13.9±4.1mm Hg on 0.6±0.9 medications in Group 2. The success rate (<18mm Hg) at 12months was 89.1% and 93.5%, respectively. Major complications included transient IOP spikes (30.4% and 37.0%) and prolonged hyphema (10.9% and 6.5%) in Group 1 and Group 2, respectively. The data showed the equivalent effects of suture trabeculotomy combined withcataract surgery and suture trabeculotomy surgery alone on postoperative safety and efficacy. None of the authors has a financial or proprietary interest in any material or method mentioned.