* BACKGROUND AND OBJECTIVE: The man agement of coexistent corneal disease and uncontrolled glaucoma continues to be a challenging clinical situation. The purpose of this study is to evaluate the results of combined penetrating keratoplasty and trabeculectomy with mitomycin-C.
* PATIENTS AND METHODS: A retrospective study was undertaken to review the records of nine patients who had corneal edema and high intraocular pressure managed by simultaneous penetrating keratoplasty and trabeculectomy with mitomycin-C.
* RESULTS: The nine patients had an average preoperative intraocular pressure of 26 mm Hg (range 17 to 41 mm Hg) and associated corneal edema. The average postoperative intraocular pressure at last follow-up was 19 mm Hg (range 5 to 53 mm Hg). Three patients needed additional procedures. Six of nine patients had intraocular pressures judged to be adequately controlled (11 ± 5 mm Hg, range 5 to 18 mm Hg) throughout the postoperative period (average follow-up 16 months). Grafts remained clear in seven patients. The grafts failed in two cases in which additional glaucoma surgery was necessary.
* CONCLUSION: Combined penetrating keratoplasty and trabeculectomy with mitomycin-C should be considered for selected patients with uncontrolled glaucoma and corneal disease who have sufficient conjunctiva for a filtering procedure.
[Ophthalmic Surg Lasers 1996;27:903-909.]
* BACKGROUND AND OBJECTIVE: The efficacy of the surgical management of pterygium with conjunctival autograft was evaluated.
* PATIENTS AND METHODS: In a retrospective survey, the records of 94 consecutive patients who underwent surgery for pterygium between 1984 and 1993 were reviewed. Only the first pterygium procedure for each patient performed at Wills Eye Hospital was included. The statistical technique of survival curve analysis by the Kaplan-Meier product limit was used to analyze the results separately after the removal of primary and recurrent pterygia.
* RESULTS: Thirty-one patients with primary pterygium underwent simple excision. Forty patients had conjunctival autografts. The recurrence rates estimated at 1 year were 40% and 16%, respectively (P = .031). In both groups, patients who were 50 years old or younger were more likely to have a recurrence (P = .029). All 23 patients with recurrent pterygium had conjunctival grafts, and the estimation of recurrence at 1 year was 25%. No serious complications occurred in any group.
* CONCLUSION: Conjunctival autograft decreases the recurrence rate for primary pterygium compared with simple excision.
[Ophthalmic Surg Lasers 1997;28:99-104.]
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