2437 The combined treatment of primary glaucoma

w In case4 of ccc&in& catamzt and glaucoma B phaccemulsificadon through a tun-ne.1 incision may be carded out in combination with uabeculectomy in order to achieve a f~tulation under the conjunctive We do such epemtiom since January 1994 and report OUT first lwJlts. Techruauc Fhaccemukif~on was paformed dwough a 6.5 mm tunnel incision. After imolantati~ of the intxaoculs lens a 1 x 1 nun section of me s&m wm cut aat of the intelioriamella of rhe tunnel. we examined 20 eyes (19 patients). Parameten of investigation WE: visual acuity, intraocular preume (IOP). rate of early complications. Two groups. each of 19 age matched eyes which in the same time period III&W& phammndsi-fication only m mbeculccmmy only saved ss umircds. Bssuk The mean time of obsuvation after the operation was 8.5 months in the gmup with combined operation. 1.8 months in the &?a~p with phawemulsiticaticm only and 8.3 months in the group wilh trakukctomy only. In the group whh combined opvstion Lc history of glaucoma lasted for 7.1 * 7.0 yeari, in that with only i&eculectomy 8.9 L 6.9 yesrs. In the group with comb&d operation the visual ax&y improved by more than wo lincs in 90 %. Mean visual acuity values increased fmm 0.23 f 0.14 IO 0.65 f 0.24 in tie group with combined operation. which was indistinguishable from the results oburined in the SOUP subjected to pkoemulsification only (impmvement of more thsn 2 lines in 90 s: i&e iu the me& values of visual awity~f&n~O.l8 5~ 0.12 to 0.60 f 0.24). In 95 % of the patients with combined opaation IOP could be successfully regulated (cri-t&c pmt-opcrative IOP < 21 mmHg ti a dmp of at least 20 % in IOP). Man IOP values decreased from 27.9 f. 4.7 to 14.7 f 3.0 mmHg in the group with combined opmtion, which was indistinguishable Gum the results obtlined in the gmup subjected to !mbeculec-!nmy only (IOP ngulalion in 95 %; da-ease in the mean values of IOP fi'om 31.8 f 7.7 to 15.1 f 3.7 m&g). Tk frequence of early complications (fibrin, tistulation, hyphaema, chomidal detphment) was higher in the group with combined operation than in the gmup wifh ph~oemulsificaion only but similar to the gmup wilh trabeculectomy only. Concluaon: The lm~m~i~ for both visual acuity and IOP bv combined Dhaaunuhifica-lion and trabccuketo~y is at least ds good as that of only pb&enwL&tion or only bx-bccukctomy. As wilh uabcculectomy …