97th DOG Annual Meeting 1999
LONG-TERM FOLLOW UP OF COMBINED PHACOEMULSIFICATION AND GONIOTREPHINATION IN PRIMARY OPEN-ANGLE GLAUCOMA AND PSEUDOEXFOLIATION GLAUCOMA
A. H. Heuring, W. W. Hütz, H. B. Eckhardt
Purpose: During the last few years combined cataract and glaucoma surgery has been regarded as a successful method of IOP control and visual rehabilitation in patients with cataract and glaucoma. Despite this, there are currently only a few data concerning the results of combined surgery for primary open-angle glaucoma (POAG) and pseudoexfoliation glaucoma (PXEG).
Methods: Included in the study were patients who underwent for the first time a combined phacoemulsification and goniotrephanation between 1993 and 1997 and were able to follow up for a minimum of 12 months after surgery (mean follow up was 39.5 months).
Results: 100 eyes with POAG (72 patients) and 22 with PXEG (19 patients) were studied. The median preoperative visual acuity of the POAG was 0,32 (PXEG 0.25), visual outcome 0.63 (PXEG 0.5). The mean preoperative IOP in PXEG (31.8 ± 10.3 mmHg) was significant higher as in POAG group (25.3 ± 6.4 mm Hg) (p=0.0004). At long-term follow up IOP decreased to 16.7 ± 2.8 mm Hg (POAG) and 15.1 ± 4.0 mm Hg (PXEG) (p<0.0001). The absolute lowering effect for PXEG versus POAG was extremely significant (p=0.0003). Before surgery all patients needed medication, whereas at follow up 59.0% (POAG) and 81.8% (PXEG) were untreated.
Conclusion: The results suggest that combined cataract and glaucoma surgery is an effective procedure of simultaneous management of cataract and glaucoma regulation. It seems that it has a favorable lowering effect for PXEG and these patients more often do not need any medications after surgery. Thereby early surgical intervention could be an advantage for this glaucoma entity.
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