1-Jahres-Ergebnisse nach kombinierter Kataraktoperation und Excimer-Laser-Trabekulotomie bei erhöhtem Intraokulardruck

Translated title of the contribution: One-year results after combined cataract surgery and excimer laser trabeculotomy for elevated intraocular pressure

M. Töteberg-Harms, P. P. Ciechanowski, C. Hirn, J. Funk

Research output: Contribution to journalArticlepeer-review

22 Scopus citations

Abstract

Glaucoma is one of the most common reasons for blindness. Usually an elevated resistance to aqueous outflow is the reason, while aqueous humor production is still normal. Medical reduction of intraocular pressure (IOP) is the first-line therapy in most cases. The gold standard of surgical treatment is trabeculectomy (TE). But TE has a lot of postoperative complications. Therefore we prefer the combined procedure of cataract extraction plus excimer laser trabeculotomy (phaco-ELT) for a selected group of glaucoma patients. Indications are cataract together with moderately elevated IOP without medical therapy or a moderate cataract together with elevated IOP under medical therapy.Patients and Methods. During ELT, 10 pores were created over 90° of the anterior chamber angle; 28 eyes of 28 patients (10 men and 18 women) were reexamined 12 months ± 2 weeks after combined phaco-ELT. Four patients were excluded because of IOP-lowering surgery during the follow-up. IOP, best corrected visual acuity, slit lamp biomicroscopy as well as glaucoma medication history (antiglaucoma drugs, AGD) were recorded.Results. The mean age was 74.33±11.81 years. The diagnosis was primary open-angle glaucoma in 9 eyes, pseudoexfoliative glaucoma in 15 eyes, ocular hypertension in 3 eyes, and 1 post-traumatic secondary glaucoma. On average, phaco-ELT could reduce the IOP by 8.79±5.28 mmHg (-34.70%, p<0.001). AGD could be reduced by 0.79±1.50 (-62.70%, p=0.017) at the same time.Conclusion. The ELT is easy to perform at the end of cataract surgery. Duration of surgery is only prolonged by 2 to 3 minutes. We found an average IOP reduction of 8.79 mmHg (-34.70%) and an average reduction of 0.79 AGD. It is known that the effect of IOP reduction is constant over time unlike argon or selective laser trabeculoplasty. If needed later on, filtering surgery is not compromised because there is no conjunctival touch during ELT and therefore no scarring of the conjunctiva. For a selected collective of glaucoma patients this procedure could be a good way to avoid trabeculectomy.

Translated title of the contributionOne-year results after combined cataract surgery and excimer laser trabeculotomy for elevated intraocular pressure
Original languageGerman
Pages (from-to)733-738
Number of pages6
JournalOphthalmologe
Volume108
Issue number8
DOIs
StatePublished - Aug 2011
Externally publishedYes

Keywords

  • Excimer laser trabeculotomy
  • Glaucoma
  • Laser surgery
  • Phacoemulsification
  • Trabecular meshwork

ASJC Scopus subject areas

  • Ophthalmology

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