98th Annual Meeting DOG 2000

V 49

Long-term results of cataract extraction combined with trabeculotomy

E. Hoffmann¹, O. Schwenn¹, F. Krummenauer², F. Grehn³, N. Pfeiffer¹

Introduction: Cararact extraction combined with trabeculotomy proved to be successful in eyes with cataract and simultaneous glaucomatous damage and/or moderately elevated eye pressure. The rare occurence of severe complications is an advantage of this operation (1). In a retrospective study we examined the long-term results of cataract extraction combined with trabeculotomy (tt, n=88) or trabeculotomy and trabeculectomy (tt/te, n=82).

Patients and methods: From November 1990 until May 1997, 170 eyes were operated in a combined manner. Via a separate corneal incision phacoemulsification (n=154) or ECCE (n=16, 13 of them 1992 and earlier) were performed.

Results: tt: IOD preoperative: mean value (mv): 24.3mmHg; median (m): 23mmHg, Quartile 1(Q1): 20mmHg, Quartile 2(Q2): 27mmHg.

IOD 12 months postop.: mv: 17.0; m: 16, Q1:13/Q3:19 (p<0.001).
IOD 24: mv:16.4; m: 16, Q1:13/Q3:18 (p<0.001).
IOD 36: mv:17.5; m: 17, Q1:15/Q3:19 (p<0.001).
IOD 48: mv:17.5; m: 18, Q1:15/Q3:19.5 (p<0.001).
IOD 60: mv:17.3; m: 18, Q1:16/Q3:19 (p=0.001).
IOD 72: mv:17.2; m: 17.5, Q1:15/Q3:19.5 (p=0.125).

The results were comparable to the group with combined trabeculotomy and trabeculectomy as antiglaucomatous procedure. The number of necessary antiglaucomatous medications could be significantly reduced after the operation.

Conclusion: The combination of cataract extraction and trabeculotomy had a sufficient IOD-decreasing effect that continued throughout the 72 months of postoperative follow-up.

Reference: (1) Schwenn O, Grehn F (1995): Cataract extraction combined with trabeculotomy. German J Ophthalmol 4: 16-20

¹Department of Ophthalmology, University of Mainz, Langenbeckstrasse 1, D-55101 Mainz, ²Coordination Centre for Clinical Trials, Johannes Gutenberg University Mainz, ³ Department of Ophthalmology, University of Würzburg