Survival probability of single site phacotrabeculectomy without MMC was not significantly different between the PACG and POAG groups. IOP reduction was greater and the need for antiglaucoma medications after surgery was lesser in the PACG group.

* BACKGROUND AND OBJECTIVE: To evaluate the surgical results and complications of mitomycin C-augmented trabeculectomy in refractory developmental glaucoma. * PATIENTS AND METHODS: The authors reviewed the charts of all patients of refractory developmental glaucoma who underwent mitomycin C-augmented trabeculectomy (0.4 mg/ml for 3 minutes) between September 1990 and August 1995. Thirtyeight eyes of 29 patients were included in the study; 34 eyes (89.5%) had refractory primary congenital glaucoma with documented failure of primary surgery, 2 eyes (5-3%) had Axenfeld-Rieger syndrome and 2 eyes (5-3%) had aniridia. The main outcome measures in this study were preoperative and postoperative intraocular pressures (IOPs) ,visual acuities, bleb characteristics, success rate, time of surgical failure, and complications. * RESULTS: The IOP (mean ± SD) reduced from a preoperative level of 32.6 ± 1 1.8 mm Hg to 12.3 ± 7.3 mm Hg (P<0.0001) with the percentage reduction in IOP being 56%. Kaplan-Meier survival analysis showed that the success probability at 18 months was 65%, which was maintained till 30 months of followup. The bleb was characterized by its large, elevated, avascular, transparent appearance in all the eyes. There were no intraoperative complications. The postoperative complications included hyphema (absorbed one week) in 8 eyes (21%), uncontrolled IOP in 8 eyes (21%), shallow anterior chamber in 3 eyes (7.9%), hypotony without visual loss in one eye (2.6%) and retinal detachment in 2 eyes (5.2%) which was surgically repaired successfully. Visual acuity was maintained in all cases after surgery. None of the patients developed mitomycin-C related late bleb-leakage or endophthalmitis. * CONCLUSION: Treatment of refractory developmental glaucoma with mitomycin C-augmented trabeculectomy is effective and safe with an acceptable rate of complications. [Ophthalmic Surg Lasers 1999;30:473-480.]

To compare the Visual outcome, intraoperative and post operative complications following early and delayed Cataract surgery in Phacolytic glaucoma. Materials and Methods: A Prospective and interventional study in a district hospital. Confirmed cases of phacolytic glaucoma after medical control grouped into group A and group B. Group A patients under went small incision cataract surgery (SICS) within 7 days (early) and group B patients after 7 days(delayed). They were compared for complications and post operative distant corrected visual acuity (DCVA) at the end of 8 weeks. Results:There were 38 eyes from 38 patients. The demographic factors and clinical findings are comparable between two group. Cumulative intraoperative complications like difficulty in doing continuous curvilinear capsulorhexis (CCC), Zonular dialysis and posterior capsule (PC) tear with vitreous disturbance were more in group B 55.6%(10/18) compare to group A 35.0% (7/20). Postoperative DCVA of 6/12 or more was comparable between two group A and B 60.0% (12/20) and 55.6 % (10/18) respectively. Post operative persistent corneal edema in 5.0% (1/20) in group A, 5.5% (1/18) persistent uveitis and 5.5% (1/18) optic nerve damage in group B observed. Conclusion: Early surgical intervention is to be preferred choice in all cases of phacolytic glaucoma. However in patients with genuine personal, family and socio economical reasons delayed surgery will not alter final visual outcome. Adequate preoperative preparation are to be taken to reduce and handle intra operative complication.