Facoesclerectomía profunda no perforanteResultados y complicaciones
- FJ Muñoz-Negrete
- G Rebolleda
- S Noval
ISSN: 0365-6691
Any de publicació: 2003
Volum: 78
Número: 9
Pàgines: 499-506
Tipus: Article
Altres publicacions en: Archivos de la Sociedad Española de Oftalmologia
Resum
Purpose: To evaluate the efficacy and safety of phaco-deep nonpenetrating sclerectomy (PDNS) with reticulated hyaluronic acid implant for glaucoma combined surgery. Material and Methods: Noncomparative retrospective study of 39 eyes of 36 patients who underwent PDNS. Preoperative and 1, 7 days, 1, 3, 6 and 12 months after surgery data retrieved were best-corrected visual acuity, intraocular pressure (IOP), number of glaucoma medications and intra and postoperative complications. Results: Mean preoperative IOP was 23.1 mm Hg (SD: 8.8). Statistically significant reduction in IOP was observed in all postoperative visits (P = 0.000); a mean IOP reduction of 8.63 mm Hg (SD: 8.55) and 6.88 mm Hg (SD: 5.46) was found 6 and 12 months after surgery respectively. Mean percentage of IOP reduction was 32.78% (SD: 21.30) and 27.74% (SD: 18.15) six and twelve months after surgery respectively. Mean preoperative number of glaucoma medications was 1.76 (SD: 0.85). In all postoperative visits a statistically significant reduction in the number of glaucoma medications was observed (P = 0.000). One year after PDNS, mean number of antiglaucoma drugs was 0.34 (SD: 0.60), and 71.9% of the eyes did not need any glaucoma medication. Predetermined target IOP was achieved in 84.2% of the eyes. A gain of almost 3 lines of mean VA was observed one year after surgery. Severe inflammatory reaction (7.7%) and hyphema (5.1%) were the most frequent observed complications. Conclusions: These preliminary results suggest that PDNS could be a safe and effective surgical technique for combining glaucoma and cataract surgery.
Referències bibliogràfiques
- Simmons, ST, Litoff, D, Nichols, DA, Sherwood, MB, Spaeth, GL. (1987). Extracapsular cataract extraction and posterior chamber intraocular lens implantation combined with trabeculectomy in patients with glaucoma. Am J Ophthalmol. 104. 465-470
- Handa, J, Henry, JC, Krupin, T, Keates, E. (1987). Extracapsular cataract extraction with posterior chamber lens implantation in patients with glaucoma. Arch Ophthalmol. 105. 765-769
- Levene, R. (1986). Triple procedure of extracapsular cataract surgery, posterior chamber lens implantation, and glaucoma filter. J Cataract Refract Surg. 12. 385-390
- Lyle, WA, Jin, JC. (1991). Comparison of a 3 and 6-mm incision in combined phacoemulsification and trabeculectomy. Am J Ophthalmol. 111. 189-196
- Weldrich, A, Menapace, R, Radax, U, Papapanos, P. (1995). Long-term results of combined trabeculectomy and small incision cataract surgery.. J Cataract Refract Surg. 21. 49-54
- Munden, PM, Alward, WL. (1995). Combined phacoemulsification, posterior chamber intraocular lens implantation and trabeculectomy with mitomycin C. Am J Ophthalmol. 119. 20-29
- Friedman, DS, Jampel, HD, Lubomski, LH, Kempen, JH, Quigley, H, Congdon, N. (2002). Surgical strategies for coexisting glaucoma and cataract: an evidence-based update. Ophthalmology. 109. 1902-1913
- Lachkar, Y, Hamard, P. (2002). Nonpenetrating filtering surgery. Curr Opin Ophthalmol. 13. 110-115
- Shaarawy, T, Karlen, M, Schnyder, C, Achache, F, Sanchez, E, Mermoud, A. (2001). Five-year results of deep sclerectomy with collagen implant. J Cataract Refract Surg. 27. 1770-1778
- Gianoli, F, Schnyder, CC, Bovey, E, Mermoud, A. (1999). Combined surgery for cataract and glaucoma: phacoemulsification and deep sclerectomy compared with phacoemulsification and trabeculectomy. J Cataract Refract Surg. 25. 340-346
- Di Staso, S, Tavertini, L, Genitti, G, Marangolo, A, Aiello, LA, Giuffré, L. (2000). Combined phacoemulsification and deep sclerectomy vs phacoemulsification and trabeculectomy. Acta Ophthalmol Scand. 232. 59-60
- Wishart, MS, Shergill, T, Porooshani, H. (2002). Viscocanalostomy and phacoviscocanalostomy: long-term results. J Cataract Refract Surg. 28. 745-751
- Negri-Aranguren, I, Croxatto, O, Grigera, DE. (2002). Midterm ultrasound biomicroscopy findings in eyes with successful viscocanalostomy. J Cataract Refract Surg. 28. 752-757
- Gimbel, HV, Penno, EE, Ferensowicz, M. (1999). Combined cataract surgery, intraocular lens implantation, and viscocanalostomy. J Cataract Refract Surg. 25. 1370-1375
- Hodapp, E, Parrish, RK, Anderson, DR. (1993). Clinical Decisions in Glaucoma. Mosby. St Louis.
- Casson, RJ, Salmon, JF. (2001). Combined surgery in the treatment of patients with cataract and primary open-angle glaucoma. J Cataract Refract Surg. 27. 1854-1863
- Rebolleda, G, Muñoz-Negrete, FJ. (2002). Phacoemulsification in eyes with functioning filtering blebs: a prospective study. Ophthalmology. 109. 2248-2255
- Shingleton, BJ, Chaudhry, IM, O'Donoghue, MW. (2002). Phacotrabeculectomy: peripheral iridectomy or no peripheral iridectomy?. J Cataract Refract Surg. 28. 998-1002
- Shin, DH, Iskander, NG, Ahee, JA, Singal, IP, Kim, C, Hughes, BA. (2002). Long-term filtration and visual field outcomes after primary glaucoma triple procedure with and without mitomycin-C. Ophthalmology. 109. 1607-1611
- Jampel, HD, Friedman, DS, Lubomski, LH, Kempen, JH, Quigley, H, Congdon, N. (2002). Effect of technique on intraocular pressure after combined cataract and glaucoma surgery: An evidence-based review. Ophthalmology. 109. 2215-2224
- Mermoud, A, Karlen, ME, Schnyder, CC, Sickenberg, M, Chiou, AG, Hediguer, SE. (1999). Nd: Yag goniopuncture after deep sclerectomy with collagen implant. Ophthalmic Surg Lasers. 30. 120-125
- Manelli, A. (2001). Manejo postoperatorio de la cirugía filtrante y sus complicaciones. Rigorma Grafica. Madrid.