Abstract
Aim: To find out surgical outcome in terms of IOP control, bleb anatomy and postoperative complications after combined surgery by using straight incision. Study design: Observational prospective study. Study centre: Conducted at tertiary health care centre. Material and methods: Study included 22 eyes of 20 patients with senile cataract and POAG (primary open angle glaucoma) who underwent SICS with trabeculectomy using straight incision were included in the study. Detailed anterior segment evaluation with IOP measurement was done on postoperative day one and then weekly for 6 weeks; thereafter at the end of 3rd, 6th and 12th month. Results: Preoperative mean IOP was 33.72 ±12.5 mm of Hg; after one year post-operative mean IOP was 12.41± 3.6 mm of Hg. Bleb was diffuse and flat comparatively. No major complications were seen. Conclusion: Straight incision for cataract extraction as well as trabeculectomy being easier for novice surgeon, with achievement of target IOP.
Highlights
Glaucoma and cataract follow a silent and highly variable natural course and are the most common causes of visual handicap in senescence
The INGOT randomized trial pioneered by Congdon et al, discovered better intraocular pressure (IOP) lowering by trabeculectomy groups (36% drop) than with medication groups (23% drop)
Where as regression model revealed 45.3% drop in IOP by trabeculectomy alone being superior to trabeculectomy using 5- fluorouracil combined with cataract surgery which brought a drop of 30.4%, at one year follow up [2]
Summary
Glaucoma and cataract follow a silent and highly variable natural course and are the most common causes of visual handicap in senescence. Since 1960, trabeculectomy has been the most successful in lowering IOP in all types of glaucoma. Two basic principles for lowering IOP are: either increase outflow by dilating available anatomical route or making an artificial passage, or decrease secretion by medical or surgical means. The INGOT randomized trial pioneered by Congdon et al, discovered better IOP lowering by trabeculectomy groups (36% drop) than with medication groups (23% drop). Where as regression model revealed 45.3% drop in IOP by trabeculectomy alone being superior to trabeculectomy using 5- fluorouracil combined with cataract surgery which brought a drop of 30.4%, at one year follow up [2]
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