Title: A comparative study of small incision cataract surgery withtrabeculectomy and extra capsular cataract extraction with trabeculectomy in efficacy of reduction in intra ocular pressure
Abstract: INTRODUCTION: Glaucoma is a chronic progressive optic neuropathy caused by a group
of ocular conditions, which lead to damage of the optic nerve with loss of
visual function. Most common risk factor is raised intra ocular pressure.
Glaucoma is a group of diseases characterized by visual field changes
and progressive optic neuropathy for which raised Intra ocular pressure is a
risk factor.
Glaucoma is the leading cause of irreversible blindness throughout the
world; glaucoma coexisting with cataract is commonly prevalent among
elderly patients. The frequent coexistence has led to many ideas as to how best
to control glaucoma and at the same time improve the vision. Many successful
designs of combined operation have been tried in last 10 years such as ECCE,
ICCE and SICS, IOL implantation combined with new filtering procedures.
Glaucoma triple procedures can provide good visual rehabilitation and
IOP control in cases of co-existing cataract and primary open angle glaucoma.
SICS has reduced surgical trauma and induced astigmatism to such a degree
that, when combined with trabeculectomy, one could expect visual
performance and intraocular pressure control as good as that with two separate
procedures.
This study is undertaken to compare the efficacy of reduction in IOP
between extra capsular cataract extraction with trabeculectomy and small
incision cataract surgery with trabeculectomy.
AIM OF THE STUDY:
To compare the efficacy of reduction in IOP between small incision
cataract extraction and posterior chamber intra ocular lens implantation with
trabeculectomy and extra capsular cataract extraction and posterior chamber
intra ocular lens implantation with trabeculectomy in cases of glaucoma
associated with cataract.
MATERIALS AND METHODS
Prospective, randomized and comparative type of study involving 50 eyes of
50 patients with glaucoma and cataract undergoing small incision cataract
surgery and posterior chamber intraocular lens implantation with
trabeculectomy and extra capsular cataract extraction and posterior chamber
intraocular lens with trabeculectomy in Government Rajaji Hospital,
Madurai Medical College, Madurai.
Duration of study
This study was done for a period of 1 year from January 2004 to January
2005, The follow up of the patients was done for a period of 12 months with
follow ups on 2nd week, 4th week, 6th week, 3rd month, 6th month and 12th
month.
Inclusion criteria
All cases of primary open angle glaucoma, primary angle closure glaucoma
and secondary angle closure glaucoma where in IOP was not controlled by
maximum medical therapy to less than 21 mm Hg having visually
significant cataract with best corrected visual acuity 6\12 and less, were
selected for the study. Exclusion criteria
• Eyes with other types of glaucoma
• Traumatic cataract
• Complicated cataract
• Subluxation of lens
• Fundus pathology affecting visual acuity
• Patients with corneal opacity
• Eyes with prior filtering surgery
Methodology
Among the patients who were seen during the recruitment period in the
ophthalmology department of Government Rajaji Hospital, we selected 50
eyes of 50 patients who satisfied our criteria to undergo surgery.
All the patients enrolled in our study received a standard ophthalmological
examination which included recording of best-corrected visual acuity, which
was determined by subjective and objective refraction with standardized
snellen’s chart.
CONCLUSION: Our study shows small incision cataract surgery with trabeculectomy
has better efficacy in reduction of IOP than extra capsular cataract extraction
with trabeculectomy.
Also small incision cataract surgery with trabeculectomy gives better
IOP control, better visual results and early visual rehabilitation, good filtering
bleb and lesser postoperative complications than extra capsular cataract
extraction with trabeculectomy.
Since our study is a short term of one year follow up only, further studies
are needed for long-term results.
Publication Year: 2006
Publication Date: 2006-09-01
Language: en
Type: dissertation
Access and Citation
AI Researcher Chatbot
Get quick answers to your questions about the article from our AI researcher chatbot