Der Ophthalmologe : Zeitschrift der Deutschen Ophthalmologischen Gesellschaft · 2000
[Combined glaucoma and cataract operation with foldable posterior chamber lens implantation. Long-term outcome and complications].
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Quentin C D, Dittmer K, Lauritzen K, Langer F, Vogel M
Аннотация
BACKGROUND: Glaucoma patients who need filtering surgery very often have cataracts as well. Combined glaucoma/cataract surgery entails a higher rate of complications and may endanger the results of glaucoma surgery.
PATIENTS AND METHODS: This retrospective study investigated 223 eyes in 169 patients with uncontrolled glaucoma and cataracts. Each eye received filtering surgery and simultaneous phacoemulsification with implantation of a foldable posterior chamber lens. Mean follow-up was 32.5 months (6-57).
RESULTS: Mean intraocular pressure was lowered from 24.6 +/- 6.2 to 16.4 +/- 3.4 mmHg (P > 0.0001). Visual acuity improved from 0.25 (0.01-0.5) to 0.5 (0.01-1.0). Preoperatively the mean number of medications was 2.4 (1-6) and postoperatively 1.3 (1 or 2). The most common perioperative complications were choroidal detachment (20.2%) and fibrin reaction in 10.1%; those occurring later than 4 weeks postoperatively were posterior capsule opacification requiring YAG laser capsulotomy (11.5%) and scarring of filtering bleb (7.7%).
CONCLUSION: Complications encountered in the combined procedure were due mainly due to cataract surgery of glaucomatous eyes with narrow pupils and posterior synechiae. A shallow anterior chamber occurred in only one case. Despite complications the success rate in lowering intraocular pressure was comparable to that observed in filtering surgery alone.
PATIENTS AND METHODS: This retrospective study investigated 223 eyes in 169 patients with uncontrolled glaucoma and cataracts. Each eye received filtering surgery and simultaneous phacoemulsification with implantation of a foldable posterior chamber lens. Mean follow-up was 32.5 months (6-57).
RESULTS: Mean intraocular pressure was lowered from 24.6 +/- 6.2 to 16.4 +/- 3.4 mmHg (P > 0.0001). Visual acuity improved from 0.25 (0.01-0.5) to 0.5 (0.01-1.0). Preoperatively the mean number of medications was 2.4 (1-6) and postoperatively 1.3 (1 or 2). The most common perioperative complications were choroidal detachment (20.2%) and fibrin reaction in 10.1%; those occurring later than 4 weeks postoperatively were posterior capsule opacification requiring YAG laser capsulotomy (11.5%) and scarring of filtering bleb (7.7%).
CONCLUSION: Complications encountered in the combined procedure were due mainly due to cataract surgery of glaucomatous eyes with narrow pupils and posterior synechiae. A shallow anterior chamber occurred in only one case. Despite complications the success rate in lowering intraocular pressure was comparable to that observed in filtering surgery alone.