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Hypotensive effect of solitary cataract phacoemulsification and combined phacoemulsification with modified trabeculopuncture in patients with primary open-angle glaucoma

Poster Details

First Author: V.Melnyk UKRAINE

Co Author(s):    O. Hurzhii              

Abstract Details

Purpose:

To assess the hypotensive effect and long-term efficacy of cataract phacoemulsification and combined phacoemulsification with modified trabeculopuncture (CPMT) in patients with primary open-angle glaucoma during 2 years of follow up.

Setting:

35 patients (35 eyes) with primary open-angle glaucoma were operated in ophthalmological department Visiobud of hospital Medbud Kiev, Ukraine.

Methods:

The primary open-angle glaucoma diagnosis was established in a period of 2 weeks before surgery without any antiglaucoma treatment. Preoperative IOP, ACD, Lens thickness (LT) and postoperative IOP were assessed in all patients. Stabilization of glaucoma was assessed with estimation of average photosensitivity and thickness of RNFL. All patients were divided into 2 groups: 18 patients underwent CP and had mean LT 4,4mm, mean ACD 2,9mm and mean IOP 20mm Hg in preoperative period, 17 patients had CPMT surgery with mean LT 4.5mm, mean ACD 3.3 mm and IOP 25.75 mm Hg before surgery.

Results:

Patients from the 2nd group had a 29% IOP reduction during the follow up period. Stabilizing of glaucoma without additional antiglaucoma medical or surgical treatment was achieved in 61.1% (11 patients) and 88.2% (15 patients) of all cases among the patients of the 1st and 2nd group respectively. Pilocarpine was used as a single antiglaucoma medication in 11.1% (2 patients) and 11.8% (2 patients) of patients from the 1st and 2nd group to achieve glaucoma stabilization. In 27.7% (5 patients) of the 1st group of patients secondary antiglaucoma surgery was applied to achieve glaucoma stabilizing.

Conclusions:

Combined phacoemulsification with modified trabeculopuncture is the operation of choice in patients with primary open-angle glaucoma. Effectiveness of IOP reduction and glaucoma stabilization quality of combined phacoemulsification with modified trabeculopuncture is significantly higher compared to solitary phacoemulsification. Solitary phacoemulsification could be performed in patients with primary open-angle glaucoma with mean LT more than 4.4 mm and mean preoperative IOP without antiglaucoma medications below 22 mm Hg. FINANCIAL DISCLOUSRE: NONE

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