Combined phacoemulsification and filtering surgery with the 'no-stitch' technique
N. Anders, T. Pham, A. Holschbach and J. Wollensak
Virchow Hospital Eye Clinic, Humboldt University, Berlin, Germany.
OBJECTIVE: To determine if intentionally making a radial incision could
lead to a lasting decrease in intraocular pressure and the development of
filtering blebs. METHODS: Forty-three eyes treated with combined filtering
surgery were compared with a control group of 42 eyes treated with cataract
surgery (phacoemulsification) alone. All of the patients had advanced
chronic open-angle glaucoma. During combined cataract and glaucoma surgery,
the tunnel floor was transected with Vannas scissors. RESULTS: One year
after surgery, the mean intraocular pressure in the study group decreased
7.6 mm Hg from a preoperative mean (+/-SD) of 25.9+/-5.3 mm Hg. The
decrease in the control group was 3.7+/-4.2 mm Hg. The difference between
the 2 groups was statistically significant (P<.001). In the study group,
an average of 1.5+/-0.8 fewer medications were required 1 year after
surgery. In the control group, 0.5+/-0.6 fewer medications were required.
CONCLUSIONS: The combined surgical procedure discussed in this article led
to a lasting decrease in intraocular pressure. Cataract surgery alone using
the no-stitch technique and posterior chamber lens implantation also
reduced intraocular pressure, although significantly less.
