Abstract:AIM: To explorethe therapeutic efficacy of treating cataract phacoemulsification remove combined with trabeculectomy early postoperative failure with open sclera flap recanalization by phacoemulsification auxiliary hook interred the anterior chamber.
METHODS:Twenty-seven cases(27 eyes)of glaucoma combined cataract surgery(3mo)in the early failure were treated with that the phacoemulsification auxiliary hook into anterior chamber under the original sclera flap, open from the inside have adhesion of the sclera flap. Postoperative follow-up 12mo, the intraocular pressure and best corrected visual acuity were observed.
RESULTS: The postoperative follow-up was 12mo. There were functional filtering bleb in 14(52%)eyes; and the IOP was below 21mmHg in 17 eyes(63%)without any anti-glaucoma drug, and in 7 eyes(26%)with 1-2 categories of lower intraocular pressure(IOP)drugs, and 3 eyes(11%), failure and the success rate was 89% after 12mo. Average intraocular pressure after 1wk, 1mo, 3mo, 6mo and 12mo were(7.1±4.3)mmHg,(10.5±5.1)mmHg,(15.1±4.8)mmHg,(16.8±5.2)mmHg,(17.3±5.1)mmHg, significantly lower than the IOP preoperatively(30.2±6.8)mmHg(P<0.01). Average visual acuity(all of the following were best corrected vision)after 1wk, 1mo, 3mo, 6mo and 12mo was(0.32±0.52),(0.52±0.42),(0.55±0.39),(0.53±0.47),(0.54±0.42). Postoperative 1wk visual acuity deeper than preoperative(0.46±0.44)(P<0.05), more than all improved compared with preoperative(P<0.05). Postoperative anterior chamber bleeding in 5(19%)eyes, all absorbed itself in 3 to 5 days; ciliochoroidal detachment in 7(26%)eyes, except one case need operate, others were conservative treatment to heal. Postoperative continuous low intraocular pressure concurrent macular edema was 1 eyes(4%), 4mo healed after treatment.
CONCLUSION: It is a safe and effective method thattreating phacoemulsification cataract remove combined with trabeculectomy early postoperative failure with open sclera flap recanalization by phacoemulsification auxiliary hook interred the anterior chamber.