Induced astigmatism and loss of endothelium cells in combined cataract and glaucoma surgery in comparison to single operation technique
J. Hans, K. Hille, S. Spang
Purpose: Operative interventions in the anterior segment like cataract and glaucoma surgery usually lead to changes of astigmatism and loss of endothelium cells. The aim of this study was to investigate the influence of combined cataract and glaucoma surgery in comparison to single cataract and glaucoma surgery.
Methods: In consecutive series we carried out a combined glaucoma surgery and a cataract extraction with phako emulsification and implantation of a foldable intraocular lens via the same incision in 34 patients. We examined vision, tension, glaucoma medication, complications and additionallly endothelial cell count and astigmatism of the cornea preoperatively, on the first and second day, three weeks and six month after surgery, respectively. We compared the results with 32 patients receiving a single goniotrephination or a cataract extraction via clear cornea with implantation of a foldable lens.
Results: Six month after operation the induced astigmatism was significant higher in patients with combined procedure (-0,57) than with cataract surgery (-0,41) and with goniotrephination (-0,25). In all three procedures there was no significant loss of endothelial cells in comparison to the preoperative values, as well as no significant differences between the different procedures.
Conclusion: Beside the reduction of the eye pressure one should hold in mine the higher change of astigmatism in combined glaucoma and cataract surgery in the choice of the best surgical procedure for the patient. The damage of endothelium cells by all three procedures can be neglected gentle operation technique provided.
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