Phacotrabeculectomy: Comparison of Results From 3.5- and 5.2-mm Incisions

Abstract

* BACKGROUND AND OBJECTIVE: To compare the intraocular pressure control, visual results, and astigmatic results of 3.5-mm and 5.2-mm incisions following phacotrabeculectomy with 12 months of follow-up. * PATIENTS AND METHODS: Fifty eyes underwent clear cornea punch trabeculectomy under a 5.0 × 2.5-mm scleral flap, closed with two 10-0 polyglactin sutures. The first 25 eyes underwent wound extension to 5.2 mm for insertion of a single-piece polymethylmethacrylate (PMMA) lens. The next 25 eyes underwent wound extension to 3.5 mm for insertion of a folded silicone lens. * RESULTS: The mean intraocular pressure decrease from the preoperative level was 7.6 mm Hg in the 3.5-mm incision group and 7.8 mm Hg in the 5.2-mm incision group. One patient required continued medication. The best-corrected visual acuity was 20/40 or better in 86% of the patients, with no significant difference between the groups. The mean "with the wound" induced astigmatism showed no statistical difference between the two groups. * CONCLUSIONS: The use of 10-0 polyglactin appears to aid filtration, yet minimizes hypotony or the need for antimetabolites. For surgeons who wish to reduce costs without compromising results during phacotrabeculectomy, there is merit in considering a 5.2-mm incision; moreover, the more rigid single-piece PMMA lens appears to be associated with fewer complications in the immediate postoperative period. [Ophthalmic Surg Lasers 1998;29:227-233.]