Сombined cataract and glaucoma surgery using modified antiglaucoma surgery

    

    Abstract

    Сombined cataract and glaucoma surgery using modified antiglaucoma surgery

    O.I. Orenburkina, A.E. Babushkin, G.Z. Israfilova, O.V. Chayka

    Ufa Eye Research Institute, Ufa

    Purpose. To develop a modified antiglaucoma operation (MAO) for the combined simultaneous surgical treatment of glaucoma and cataracts and to evaluate the effectiveness of this antiglaucoma component in comparison with trabeculectomy and non-penetrating deep sclerectomy.

    Material and methods. 61 patients (65 eyes) with a combination of incomplete complicated cataract and previously unoperated POAG stages I–III. The patients were divided into 3 groups: 1st group (control) – 17 patients, 17 eyes with ultrasonic cataract phacoemulsification (PEC) and non-penetrating deep sclerectomy (NPDS); 2nd (control) group (25 patients, 28 eyes) of patients with PE and trabeculectomy (TE); 3rd (main) group (19 people, 20 eyes) – FEC with developed MAO (based on the NGSE technique with cyclodialysis, also including elements of iridocycloretraction and autosclercyclostomy). All patients underwent a comprehensive ophthalmological examination, which included the determination of visual acuity, kinetic perimetry, non-contact tonometry, biomicroscopy, ophthalmoscopy, and optical coherence tomography (OCT). Hypotensive and visual results were assessed a week later and in the long term after surgery. The maximum follow-up period for patients did not exceed 1.5 years (average 12.4 months).

    Results. Approximately equal hypotensive results in the long-term period were shown by combined operations, which included FEC with TE (absolute effect, i.e. without additional medication – in 65 % of cases) and MAO (respectively, in 60 %). A more modest result was recorded after FEC and NGSE – 41.7 %. However, the number of early postoperative complications after the latter turned out to be almost 2 times less than after simultaneous intervention with penetrating TE (28.5 %), and was quite comparable with that after FEC and NGSE (15 % and 11.8 %). At the same time, the best visual results in the studied terms were observed in the main (0.78 ± 0.06) and 1st control (0.70 ± 0.07) groups, the worst – after FEC (0.64 ± 0.05).

    Conclusion. Modified antiglaucoma surgery in combination with FEC in POAG surgery and complicated cataract in the long term provides a higher absolute hypotensive effect (60 %) than simultaneous surgical intervention using non-penetrating deep sclerectomy (41.7 %). At the same time, the developed operation is practically not inferior in this indicator to fistulizing trabeculectomy (65 %), but significantly exceeds it both in safety (the number of complications is almost 2 times less) and in visual acuity in the long term (0.78 ± 0.06 versus 0.64 ± 0.05, p < 0.05).

    Keywords: cataract, glaucoma, simultaneous combined surgery, phacoemulsification, modified antiglaucoma surgery

    

    For quoting: Orenburkina O.I., Babushkin A.E., Israfilova G.Z., Chayka O.V. Сombined cataract and glaucoma surgery using modified antiglaucoma surgery. Point of view. East – West. 2022;3:17–23. https://doi.org/10.25276/2410-1257-2022-3-17-23

    

    Corresponding author: Israfilova Gulnara Zufarovna, israfilova_gulnara@mail.ru