Combined surgery for cataract and open-angle glaucoma by a modified technique of partially fistulizing surgery

Purpose. To evaluate the clinical and functional results of a combined intervention - one-stage cataract phacoemulsification and a newly developed version of partially fistulizing antiglaucoma surgery (PFS) of patients with primary open-angle glaucoma (POAG) as compared with those of phacoemulsification in combination with penetrating and non-penetrating antiglaucoma intervention.

Material and methods. 61 patients (65 eyes) with a combination of incomplete complicated cataract and previously unoperated stages I–III POAG. were divided into 3 groups: group 1 (control, 17 patients, 17 eyes) with ultrasonic cataract phacoemulsification (PEC) and non-penetrating deep sclerectomy (NPDS); 2 group 2 (control, 25 patients, 28 eyes patients with PEC and trabeculectomy (TE); group 3 (main, 19 patients, 20 eyes) with PEC and the newly developed PFS.

Results. The best long-term results, with approximately equal hypotensive parameters were achieved with combined operations, which included PEC with TE (the absolute effect achieved in 65% of cases) and PFS (in 60%). However, the number of early postoperative complications after PFS turned out to be almost 2 times as small as after a simultaneous intervention with penetrating TE, and was wholly comparable with that after NPDS (15 and 11.8%). At the same time, the best visual results over the relevant period were observed in the main (0.78 ± 0.06) group and the control group 1 (0.64± 0.05).

Conclusion. Combined simultaneous intervention, including cataract phacoemulsification with the newly developed partially fistulizing antiglaucoma surgery, is an effective way to improve visual acuity, normalize intraocular pressure and stabilize glaucomatous optic neuropathy, as well as to reduce the drug load on the patient.

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