Combined Cataract and Glaucoma Surgery: An assessment of 68 eyes in an eye hospital in Lagos, Nigeria
Objective: To assess the best corrected visual acuity and average intraocular pressure at 6 months and one (1) year in patients with cataracts in glaucoma that had combined trabeculectomy and cataract surgery with lens implantation. Methods: A retrospective review of the case notes of patients who underwent combined glaucoma and cataract surgery with lens implantation in a private eye centre, The Eye Foundation Hospital, was carried out, using the following parameters: age, pre-operative intraocular pressure (IOP), post-operative intraocular pressure preoperative and postoperative visual acuity, the number of preoperative antiglaucoma medications, and the number of postoperative antiglaucoma medications at one (1) year or more. Results: 68 eyes of 67 patients were assessed during the study. Thirty-one (44.93%) had preoperative visual acuity (VA) of light perception (LP) -6/60 (very poor). At 6 months post operatively, 50 patients were followed up, 40% (n=20) had a visual acuity of 6/12-6/5 (very good). At one year, 37 patients followed up, of those, 48.65% (n=18) maintained a visual acuity of 6/12-6/5(very good). Mean preoperative intraocular pressure was 18.96 ± 7.38mmHg. At 6 months, mean IOP was 11.77± 3.61mmHg; one (1) year postoperatively IOP was 13.93 ± 3.21mmHg. There was a statistically significant improvement in VA (p<0.05) and intraocular pressure (p = 0.05). Conclusion: Combined trabeculectomy and cataract surgery should be considered as a good operative choice in elderly patients who present with significant cataracts in glaucoma and who require two or more antiglaucoma drugs to maintain a normal intraocular pressure. Though a more difficult operation than either procedure alone, good results can be achieved in experienced hands with significant improvement in VA (p<0.05) and Intraocular pressure(p=0.05).
Keywords: combined cataract / glaucoma surgery, intraocular pressure, visual acuity
Nigerian Journal of Opthalmology Vol. 15 (2) 2007: pp. 57-60