Efficacy of trabeculectomy and manual small incision cataract surgery with posterior chamber intraocular lens implantation

AUTHOR(s) : Deka Rita, Das Babi, Nath Anamika
DOI No. : 10.31741/ijhrmlp.v5.i2.2019.11

ABSTRACT :
Glaucoma co-existing with cataract is frequently encountered in the practice of ophthalmology. The proposed study aims to evaluate the results of Trabeculectomy and manual small incision cataract surgery with posterior chamber intraocular lens implantation (Triple procedure) in cataract with glaucomatous eyes on intraocular pressure control, and visual outcome. Materials and methods: The study was conducted on 30 cases admitted in the Regional Institute of Ophthalmology, Gauhati Medical College. Cataract cases co-existing with primary open-angle glaucoma previously receiving maximally tolerated medication, but with poor control; chronic angle-closure glaucoma; intraocular pressure above 22mm of Hg and a visually significant cataract; lens-induced glaucoma with field defect in the other eye; pigmentary glaucoma were only included for the study. A thorough ocular examination with a slit lamp, tonometry, gonioscopy, ophthalmoscopy, field charting and operative procedure with pre-operative and post-operative care was performed after taking informed consent. Results: The mean age of the patients were 55.5 years. Thirty eyes of 30 patients underwent trabeculectomy and SICS with PCIOL. The follow-ups were 6 weeks and 6 months. There is a significant decrease in intraocular pressure both in first and second post-operative check-up (P<.05). However, there is no significant difference in intraocular pressure between first and second post-operative check-up (P>.05). In the present study, it was found that visual acuity was improved after the surgical procedure in both first and second post-operative check-up as 86.67% and 84.21% respectively. Discussion: Triple procedure (Trabeculectomy and manual small incision cataract surgery with posterior chamber intraocular lens implantation) offers better visual rehabilitation, avoids multiple surgeries, economically more feasible and controls intraocular pressure adequately.

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