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Impressum
Postoperative complications and intraocular pressure after combined phacoemulsification with IOL-implantation and trabeculectomy in glaucoma-patients with and without pseudoexfoliation syndrome (PEX).
Schumacher S., Küchle M., Händel A., Groh M. J. M., Naumann G. O. H.
Departement of Ophthalmology, University Erlangen-Nürnberg, Schwabachanlage 6, D-91054 Erlangen
Backround: Comparison of the results after combined ecce/HKLimplantation
and trabeculectomy in patients with and without PEX.
Methods and patients: We examined retrospectively 40 eyes (20 with
PEX) that underwent surgery between 1998-2000 by 3 experienced surgeons.
In 35 eyes a corneoscleral incision for cataract surgery was performed,
in 5 patients a corneal incision was used. Mean postoperative followup
was 5.5 months.
Results: Mean postoperative visual acuity was 0.34 ± 0.3
with PEX versus 0.4 ± 0.25 without PEX in comparison to the preoperative
visual acuity from 0.31 ± 0.2 versus 0.24 ± 0.18. Early
postoperative complications were an increasing of intraocular pressure
> 21mmHg in 9 eyes (6 eyes with PEX, 3 without PEX), fibrin formation
in20 eyes (5 with PEX, 8 with-out PEX), shallow anterior chamber in 4
eyes (1 with PEX, 3 without PEX), and hyphema in 8 patients (4 with PEX,
4 without PEX). No flat anterior chamber was seen in our patients. Late
postoperative mean intraocular pressure in eyes with and without PEX was
19.5 ± 6.9 mmHg versus 16.0 ± 6.9 (17 eyes with PEX, 14
eyes without PEX). 6 eyes showed a rise in intraocular pressure > 21mmHg
(5 eyes with PEX, 1 eye without PEX), additional pressure-lowering drugs
were used in 3 patients (2 with PEX, 1 without PEX).
Conclusion: The combined operation performed by experienced surgeons
offers simultaneous lowering of intraocular pressure and rehabilitation
of visual acuity. Comparing early postoperative complications in eyes
with and without PEX, no marked differences were seen. In eyes with PEX
visusal rehabilitation and intraocular pressure in the long term follow
up was slightly worse.