Phakoemulsifikation kombiniert mit Zyklophotokoagulation

Abstract

Cyclophotocoagulation and phacoemulsification procedures may be combined to treat patients with glaucoma and cataract. To the best of our knowledge data concerning this combination have not been published as yet. 28 eyes (23 patients, mean age 78.1 +/- 7.6 years) were operated upon between 9.04.2002 and 29.06.2004. Patients were compared to a group with phacoemulsification alone. A median of 15 laser flashes (duration 2000 ms, power 1750 mW) were applied. Complications at discharge from hospital (and after 6 weeks) were: corneal oedema 18 % (4.0 %), fibrinous reaction 25 % (7.1 %), hyphaema 7.1 % (0 %), 1 decentred IOL, 7.1 % capsular tear. Visual acuity increased statistically significantly from 0.3 to 0.5. Mean intraocular pressure decreased statistically significantly from 23.7 +/- 5.6 mmHg to 16.0 +/- 3.4 mmHg after 166 days. Success rate was 76 % after 6 weeks and 85.7 % after 166 days. The mean number of antiglaucomatous drugs could be reduced from 1.6 to 1.1 after 166 days. In the control group there was a transient corneal edema in 14.3 % (7.1 % cornea guttata), other complications were not found. The combination of cyclophotocoagulation and phacoemulsification is as successful as other combinations of cataract and glaucoma surgery with a similar or lower complication rates. Cyclophotocoagulation is cost efficient, can be repeated and is adaptable to the intraocular pressure.