Session Title: Cataract I
Session Date/Time: Friday 15/02/2013 | 10:30-12:30
Paper Time: 12:10
Venue: Hall 2
First Author: : A.Saeed EGYPT
Co Author(s): :
Purpose:
To compare the efficacy and safety of either phacoemulsification alone or combined phacotrabeculectomy with adjunctive mitomycin-C (MMC) in the surgical treatment of medically controlled chronic angle closure glaucoma (CACG) with coexisting cataract guided by ultrasonic biomicroscopy (UBM) imaging to evaluate the morphological changes of the anterior chamber (AC).
Setting:
Ophthalmology Department, Benha University hospital, Benha, Egypt.
Methods:
Forty eight eyes of 38 patients were included in this randomized clinical trial. They were equally divided into group A (phacoemulsification alone) and group B (combined phacotrabeculectomy with MMC). UBM was completed 1 month postoperatively to measure AC parameters: mean AC depth, trabecular-iris angle (TIA) and angle opening at 500µm (AO 500). The patients were evaluated at 3, 6, 12, 18 and 24 months postoperatively with documentation of the IOP, number of IOP-lowering drugs, BCVA, gonioscopy, complications, additional maneuvers required to maintain filtration or to handle complications, and any additional surgical intervention. Perimetry was overseen at 12 and 24 months.
Results:
Both groups succeeded in achieving lower mean IOP values with statistically significantly less antiglaucoma drugs. The mean IOP showed no statistically significant differences between both groups preoperatively and postoperatively. Group B showed a mean of 0.96 mmHg lower IOP, with 0.21 mean decreases of the antiglaucoma drugs, both with no statistical significance in comparison to group A. Both groups showed statistically significant increases in all AC parameters postoperatively. However, only the mean AC depth was statistically significantly higher in group A than B. Group B was associated with significantly more intra and post-operative complications, as well as additional interventions than in group A.
Conclusions:
Phacoemulsification could be recommended as an initial line of treatment for medically controlled CACG with coexisting cataract. Although combined phacotrabeculectomy can achieve relatively better IOP control with less drug dependence, it may be associated with more complications and additional surgical interventions.
Financial Disclosure:
None
