Combined cataract and glaucoma surgery: trabeculectomy versus endoscopic laser cycloablation

J Cataract Refract Surg. 1999 Sep;25(9):1214-9. doi: 10.1016/s0886-3350(99)00141-8.

Abstract

Purpose: To determine whether combined cataract surgery with endoscopic laser cycloablation produces less inflammation than cataract surgery combined with a filtering procedure.

Setting: Taylor Regional Hospital (surgeries) and EyeSight Associates (examinations), Warner Robins, Georgia, USA.

Methods: A randomized prospective study was conducted of 58 eyes of 58 patients comparing endoscopic laser cycloablation performed through a cataract incision at the time of cataract surgery with combined trabeculectomy and cataract surgery.

Results: Mean follow-up was 2 years. At the final available visit, 30% of endoscopic laser patients achieved intraocular pressure control (below 19 mm Hg) without medication and 65% with medication. Forty percent of trabeculectomy patients achieved control without medication and 52% with medication. Four endoscopic laser patients (14%) and 3 trabeculectomy patients (10%) were considered treatment failures (required additional surgical intervention).

Conclusion: Endoscopic laser cycloablation performed through a cataract incision was a reasonably safe and effective alternative to combined cataract and trabeculectomy surgery, providing an option for cataract patients who have glaucoma requiring surgical intervention.

Publication types

  • Clinical Trial
  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Cataract / complications
  • Ciliary Body / surgery*
  • Endoscopy
  • Female
  • Fluorouracil / therapeutic use
  • Follow-Up Studies
  • Glaucoma / complications
  • Glaucoma / drug therapy
  • Glaucoma / surgery*
  • Humans
  • Intraocular Pressure
  • Laser Therapy / methods*
  • Lens Implantation, Intraocular
  • Male
  • Mitomycin / therapeutic use
  • Phacoemulsification*
  • Prospective Studies
  • Trabeculectomy / methods*
  • Treatment Outcome
  • Visual Acuity

Substances

  • Mitomycin
  • Fluorouracil