2020, Number 2
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Rev Cub Oftal 2020; 33 (2)
Two-site phacotrabeculectomy as combined therapy for patients with glaucoma and cataract
Cárdenas CD, Sánchez AL, Fumero GFY, Tie W, Múzquiz JMA, Pérez FA
Language: Spanish
References: 22
Page: 1-13
PDF size: 303.37 Kb.
ABSTRACT
Objective:
Determine the results of two-site phacotrabeculectomy as combined therapy for Cuban patients with glaucoma and cataract.
Methods:
An observational prospective longitudinal descriptive study was conducted of Cuban patients undergoing phacotrabeculectomy at the Glaucoma Service of Ramón Pando Ferrer Cuban Institute of Ophthalmology from June 2016 to April 2017.
The study universe was all the patients undergoing two-site phacotrabeculectomy. The sample was patients operated on by the same surgeon who consented to participate in the research. Patients with a history of intraocular surgery were excluded, as well as those who could not be followed up at the institution. The variables considered were age, sex, skin color, best corrected visual acuity, intraocular pressure, number of ocular hypotensive drugs, and complications developed. Follow-up extended for two years with visits on the next day, at seven and thirty days, at three and six months, and at one and two years.
Results:
Thirty-one patients were observed. Mean age was 70 years, with a predominance of the female sex and non-white skin color. Best corrected visual acuity was 0.58 preoperative and 0.73 postoperative. Mean preoperative intraocular pressure was 22.04 mmHg, whereas at two years it was 16.37 mmHg. Hypotensive drugs averaged 3.0 preoperative and 0.3 at two years. The most common complications were intraoperative posterior capsule rupture and postsurgical posterior capsule opacity.
Conclusions:
Two-site phacotrabeculectomy reduces intraocular pressure, improves best corrected visual acuity and lowers the number of ocular hypotensive drugs for at least two years. The complications associated to the technique are minimum.
REFERENCES
De Moraes CG, Liebmann JM, Levin LA. Detection and measurement of clinically meaningful visual field progression in clinical trials for glaucoma. Prog Retin Eye Res. 2017;56:107-47.
Song P, Wang J, Bucan K, Theodoratou E, Rudan I, Chan KY. National and subnational prevalence and burden of glaucoma in China: A systematic analysis. J Glob Health. 2017;7(2):020705.
Chan EW, Li X, Tham YC, Liao J, Wong TY, Aung T, et al. Glaucoma in Asia: regional prevalence variations and future projections. Br J Ophthalmol. 2016;100:78-85.
United Nations. World population ageing. New York: Department of Economic and Social Affairs, United Nations; 2015.
Shetty P. Grey matter: ageing in developing countries. Lancet. 2012;379:1285-7.
World Health Organization. World report on ageing and health. Geneva: World Health Organization; 2015.
American Academy of Ophthalmology. Glaucoma. EE.UU.: American Academy of Ophthalmology (Basic and Clinical Science Course); 2017.
Kung JS, Choi DY, Cheema AS, Singh K. Cataract surgery in the glaucoma patient. Middle East Afr J Ophthalmol. 2015;22(1):10-7.
Baig N, Kam KW, Tham CC. Managing Primary Angle Closure Glaucoma - The role of lens extraction in this era. Open Ophthalmol J. 2016;10:86-93.
Zhang ML, Hirunyachote P, Jampel H. Combined surgery versus cataract surgery alone for eyes with cataract and glaucoma. Cochrane Database Syst Rev. 2015;7(7):CD008671.
El-Sayyad F, Helal M, El-Maghraby A, Khalil M, El-Hamzawey H. One-site versys 2-site phacotrabeculectomy: a randomized study. J Cataract Refract Surg. 1999;25:77-82.
Tseng VL, Coleman AL, Chang MY, Caprioli J. Aqueous shunts for glaucoma. Cochrane Database Syst Rev. 2017;7(7):CD004918.
Park SJ, Lee JH, Kang SW, Hyon JY, Park KH. Cataract and Cataract Surgery: Nationwide Prevalence and Clinical Determinants. J Korean Med Sci. 2016;31(6):963-71.
Ministerio de Salud Pública. Anuario Estadístico de Salud 2015. La Habana: Dirección Nacional de Registros Médicos y Estadísticas de Salud; 2016.
Kyari F, Abdull MM, Bastawrous A, Gilbert CE, Faal H. Epidemiology of glaucoma in sub-saharan Africa: prevalence, incidence and risk factors. Middle East Afr J Ophthalmol. 2013;20(2):111-25.
Gupta P, Zhao D, Guallar E, Ko F, Boland MV, Friedman DS. Prevalence of glaucoma in the United States: The 2005-2008 National Health and Nutrition Examination Survey. Invest Ophthalmol Vis Sci. 2016;57(6):2905-13.
Albis-Donado O, Sánchez-Noguera CC, Cárdenas-Gómez L, Castañeda-Diez R, Thomas R, Gil-Carrasco F. Achieving Target Pressures with Combined Surgery: Primary Patchless Ahmed Valve Combined with Phacoemulsification vs. Primary Phacotrabeculectomy. J Curr Glaucoma Pract. 2015;9(1):6-11.
Chelerkar V, Parekh P, Kalyani VKS, Deshpande M, Khandekar R. Comparative clinical study of medically controlled nonsevere chronic primary angle-closure glaucoma with coexisting cataract surgically managed by phacoemulsification as against combined phacotrabeculectomy. Middle East Afr J Ophthalmol. 2018;25(3-4):119-25.
Jung J, Isida-Llerandi CG, Lazcano-Gómez G, SooHoo JR, Kahook MY. Intraocular pressure control after trabeculectomy, phacotrabeculectomy and phacoemulsification in a hispanic population. J Curr Glaucoma Pract. 2014;8(2):67-74.
Choy BNK. Comparison of surgical outcome of trabeculectomy and phacotrabeculectomy in Chinese glaucoma patients. Int J Ophthalmol. 2017;10(12):1928-30.
Gutiérrez Castillo M, Ramos Pereira Y, Rodríguez Suárez B, Hormigó Puertas I, Montero Díaz E, Barroso Lorenzo R. Ruptura de la cápsula posterior en la cirugía del cristalino. Rev Cubana Oftalmol. 2019;32(1):2.
Rodríguez Suárez B, Hernández Silva J, Pérez Candelaria E, Duque de Estrada A, Hormigó Puertas I, Santisteban García I. Cirugía de catarata por facoemulsificación aplicando la técnica de prechop. Rev Cubana Oftalmol. 2013;26(1):5.