Official ESCRS | European Society of Cataract & Refractive Surgeons


Effectiveness of combined cataract and glaucoma surgery in different stages of open-angle glaucoma patients

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Session Details

Session Title: Glaucoma Management

Session Date/Time: Monday 16/09/2019 | 16:30-18:00

Paper Time: 17:42

Venue: Free Paper Forum: Podium 4

First Author: : V.Melnyk UKRAINE

Co Author(s): :                                 

Abstract Details


We perposed combined phacoemulsification with modified tunnel trabeculopuncture in patients with open-angle glaucoma in 2012. 568 patients (89%) didn't need any hypotensive drops or another operations during 5 years after surgery. 70 patients (11%) were necessary to use hypotensive drops or trabeculectomy in different periods after surgery. The main reasons of these phenomena were high IOP or developing of the optic nerve atrophy. We essesed preoperative stage of glaucoma and IOP of these patients to determine what is the main reason of low compensation of glaucoma after surgery.


All patients were operated by one surgeon and were controlled in Clinic "Visiobud-Plus" in Kyiv, Ukraine during 5 years from 2011 till 2016.


Age of the patients was 46-82 years old. All patients had primary open-angle glaucoma. We used combined cataract and glaucoma surgical technique. 511 patients (80%) had glaucoma associated with PEX. We examined preoperative and postoperative IOP, stages of glaucoma according to the computer's perimetry and OCT of optic nerve. All patients were divided on three groups: 1) mild and moderate stage of glaucoma, 2) severe stage of glaucoma and 3) advanced glaucoma. IOP more then 23 mmHg or developing of atrophy of the optic nerve were the reasons of prescription of hypotensive drops or trabeculectomy.


In the first group - 287 eyes (45%) - glaucoma was compensated in 278 cases (97%) after surgery. In the second group - 306 eyes (48%) - glaucoma was compensated in 269 cases (88%). In the third group - 45 eyes (7%) - glaucoma was compensated in 21 cases (47%). Compensation between patients with PEX was 97% and between patients with no PEX was only 77%.


Our investigation showed a high hypotensive effect of combined phacoemulsification with modified tunnel trabeculopuncture in patients with primary open-angle glaucoma. Effectiveness of surgery depends on the stage of glaucoma. Surgery on the early stages gives the best results. Vice versa patients with advanced glaucoma had low level of IOP compensation and it was necessary to use additive methods of treatment. Patients with open-angle glaucoma associated with PEX had better results in comparison of patients without PEX.

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