Comparative Study of Silicone versus Acrylic Foldable Lens Implantation in Primary Glaucoma Triple Procedure

Lemon, Lance C; Shin, Dong Ho; Song, Man S.; Lee, Jin H.; Juzych, Mark S; Hughes, Bret A.

doi:10.1016/s0161-6420(97)30076-1

Cited by 14 publications

(12 citation statements)

References 7 publications

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“…Our results differ from those of Lemon et al (9) the mean IOP on the first postoperative day was lower in the silicone group than in the other groups, but without statistical significance (p=0.48). From the first day onwards, IOPs were very similar in all groups.…”

Section: Discussioncontrasting

confidence: 99%

“…As seen in other studies (5,(8)(9) , our three groups showed a significant improvement in visual acuity postoperatively.…”

Section: Discussionsupporting

confidence: 90%

“…A study with rabbit models (15) , also reported more pronounced fibrin reaction in eyes with silicone IOL. In contrast, other authors (9) did not mention the occurrence of anterior chamber fibrin reaction or lens deposits in any of the IOL groups. Unlike the results found in the literature (16) , we did not find any association between early postoperative hypotony and fibrin effusion into the anterior chamber.…”

Section: Discussionmentioning

confidence: 83%

“…In a prospective study (9) with foldable silicone and acrylic IOLs in phacotrabeculectomies, using mitomycin C (MMC) in most of the eyes, a between-groups discrepancy was found when mean IOPs in the first postoperative month were compared (14.1±5.0 mmHg and 11.2±3.9 mmHg for the acrylic and silicone groups respectively) (p=0.005). The authors attributed this significantly higher mean IOP found in the acrylic visual acuities were significantly better than mean preoperative visual acuities (p<0.001).…”

Section: Discussionmentioning

confidence: 99%

“…Phacoemulsification has also become very popular with surgeons when considering cataract removal because of its several advantages when compared to extracapsular cataract extraction. For those patients with coexisting glaucoma and cataract, combining trabeculectomy and phacoemulsification with intraocular lens (IOL) implantation has proved to be an effective approach (2)(3)(4)(5)(6)(7)(8)(9) . In addition to innovated surgical techniques, new foldable intraocular lenses have been developed from different materials and, as a consequence, smaller incisions can now be used for either phacoemulsification alone or combined trabeculectomy and phacoemulsification with IOL implantation, thus minimizing intraoperative risks and enhancing postoperative recovery.…”

Section: Introductionmentioning

confidence: 99%

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Comparison of PMMA, foldable silicone and foldable acrylic hydrophobic intraocular lenses in combined phacoemulsification and trabeculectomy

Serpa¹,

Wishart²

2005

Arq. Bras. Oftalmol.

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Comparison of PMMA, foldable silicone and foldable acrylic hydrophobic intraocular lenses in combined phacoemulsification and trabeculectomy Purpose: To compare the postoperative results of phacotrabeculectomy with implantation of PMMA, foldable silicone or foldable hydrofobic acrylic intraocular lens (IOL). Setting: Glaucoma unit, The Royal Liverpool University Hospital, Liverpool, United Kingdom. Methods: We studied a total of 124 eyes of three consecutive groups of patients with glaucoma and cataract that underwent phacotrabeculectomy with implantation of a PMMA (30 eyes), a foldable silicone (57 eyes) or a foldable acrylic (37 eyes) IOL. Postoperative Snellen visual acuity and intraocular pressure (IOP), and early and late complications were assessed. All data were analyzed by means of χ 2 test, Fisher's exact test, ANOVA/MANOVA tests or a combination whenever appropriate. Results: In all three groups the early and late mean postoperative IOPs were significantly lower than the preoperative ones (p<0.001), with no intergroup differences (p=0.48). The number of eyes with early postoperative hypertension (IOP>25 mmHg) and hypotony (IOP<7 mmHg) was similar in the three groups (p=0.91 and p=0.92 respectively). All groups showed improvement in mean visual acuity (p<0.001), and the differences among the groups were not significant (p=0.79). By 9-12 months after surgery IOPs lower than 22 mmHg without glaucoma medication were found in 76.9% in the PMMA group, 76.6% in the silicone group and in 76.9% in the acrylic group. At the same interval, best visual acuity of 6/12 or better was attained in 80.8%, 83% and 80.8%, in the PMMA, silicone and acrylic groups respectively. The silicone group had significantly more postoperative fibrin reaction into the anterior chamber (p=0.01) and giant cell deposits on the IOL (p<0.0001) than the PMMA and the acrylic groups. The rate of Yag laser posterior capsulotomy was lower with the acrylic IOL (0%) than with the silicone (12.2%) or PMMA (13.3%) IOLs (p=0.08). Conclusion: In patients with glaucoma and cataract, phacotrabeculectomy with PMMA, silicone or acrylic IOL was equally effective in lowering the IOP and improving visual acuity. However, incidence of fibrin reaction and lens deposits was higher in those eyes which received a silicone IOL. The PMMA and the acrylic groups did not differ with respect to postoperative complications, but those eyes with an acrylic IOL had a lower rate of posterior capsule opacification.ABSTRACT

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Section: Discussioncontrasting

confidence: 99%

“…As seen in other studies (5,(8)(9) , our three groups showed a significant improvement in visual acuity postoperatively.…”

Section: Discussionsupporting

confidence: 90%

Section: Discussionmentioning

confidence: 83%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Comparison of PMMA, foldable silicone and foldable acrylic hydrophobic intraocular lenses in combined phacoemulsification and trabeculectomy

Serpa¹,

Wishart²

2005

Arq. Bras. Oftalmol.

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Comparative Study of Trabecular Aspiration vs Trabeculectomy in Glaucoma Triple Procedure to Treat Pseudoexfoliation Glaucoma

Jacobi

Dietlein²,

Krieglstein³

1999

Arch Ophthalmol

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To establish the relative safety and effectiveness of trabecular aspiration in combination with phacoemulsification and intraocular lens (IOL) implantation (asp+IOL) for decreasing intraocular pressure (IOP), and to compare the outcome of this method of treatment with that of phacoemulsification and IOL implantation alone (IOL-alone) or standard filtering glaucoma triple procedure (triple procedure). Design: Prospective, controlled study randomized with respect to assignment to trabecular aspiration, with a casecontrol design between the asp+IOL and triple procedure groups. Participants: Seventy-four eyes of 74 patients with uncontrolled pseudoexfoliation glaucoma without a history of previous intraocular or extraocular surgery and in need of cataract surgery. Forty-eight patients were randomized to those receiving adjunctive trabecular aspiration (asp+IOL group of 26 eyes) and those given no trabecular aspiration (IOL-alone group of 22 eyes). The triple procedure group consisted of 26 cases, closely matched to the asp+IOL cases in terms of age, sex, cupdisc ratio, glaucoma medication requirements, and systemic diseases. Interventions: Temporal clear corneal phacoemulsification and foldable IOL implantation was performed in all eyes. In the asp+IOL group, trabecular aspiration was performed with a suction force of 100 to 200 mm Hg under light tissue-instrument contact using a modified intraocular aspiration probe. A modified Cairns-type trabeculectomy without adjunctive antimetabolites was performed superiorly in the triple procedure eyes after IOL implantation. Main Outcome Measures: Surgical outcome was assessed in terms of IOP change, need of adjunctive glaucoma medication, visual acuity outcome, and complications. Surgical failure was defined as an outcome requiring additional surgical intervention or more than 1 medication to achieve IOP control to the target pressure. Results: Two years after surgery, success rates were 36%, 64%, and 78% in the IOL-alone, asp+IOL, and triple procedure groups, respectively (PϽ.001). Hyphema (46%) and ocular hypotony (11%) were observed in the triple procedure group only, whereas blood reflux (61%) and descemetolysis (19%) were seen exclusively in the asp+IOL group. Conclusions: In pseudoexfoliative eyes, asp+IOL is significantly more effective than cataract surgery alone in reducing postoperative IOP and the necessity for glaucoma medication. Although trabecular aspiration in the triple procedure did not achieve pressure control in all patients, especially in the low target pressure range, the risk profile appears to be more favorable in the trabecular aspiration-treated eyes than in the filtering glaucoma triple procedure group. Trabecular aspiration in the glaucoma triple procedure could serve as a possible first-line treatment for pseudoexfoliative eyes with coexisting cataract and glaucoma.

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Combined Cataract and Trabeculectomy Surgery

Johnson

2009

Cataract Surgery in the Glaucoma Patient

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Comparative Study of Silicone versus Acrylic Foldable Lens Implantation in Primary Glaucoma Triple Procedure

Cited by 14 publications

References 7 publications

Comparison of PMMA, foldable silicone and foldable acrylic hydrophobic intraocular lenses in combined phacoemulsification and trabeculectomy

Comparison of PMMA, foldable silicone and foldable acrylic hydrophobic intraocular lenses in combined phacoemulsification and trabeculectomy

Comparative Study of Trabecular Aspiration vs Trabeculectomy in Glaucoma Triple Procedure to Treat Pseudoexfoliation Glaucoma

Combined Cataract and Trabeculectomy Surgery

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