Purpose: To evaluate the midterm effects of two-site phacotrabeculectomy with limbal-based conjunctival flap and microincisinal trabeculectomy with adjustable sutures.
Design: and method: The charts of 115 patients (188 eyes) were retrospectively reviewed. Patients had a mean age of 74.7 years and were all operated by the same surgeon between 2001 and 2003. The surgery consisted of a clear cornea phacoemulsification and a microtrabeculectomy with limbal-based conjunctival flap. The number of sutures on the scleral flap was adjusted according to the filtration.
Results: The mean preoperative IOP was 17.7 +/- 3.94 mmHg, and the mean number of antiglaucomatous medications was 2.05 +/- 0.86. The last postoperative IOP was 13.2 +/- 2.81 mmHg with a mean of 0.8 +/- 0.8 medications. Mean follow-up was 29.8 months (1-7 years). Visual acuity improved by at least two lines in 154 eyes (81%), stabilized (+/- 1 line) in 33 eyes (17.37%), and worsened of more than two lines in one eye (1.63%). Early postoperative complications were seven Seidels (3.68%), one shallow anterior chamber (0.55%), three chorioretinal detachments (1.58%), six hyphemas (3.15%), one iris incarceration (0.55%), and eight corneal edemas (4.21%). Late complications were five cases of bleb fibrosis despite needling and 5-FU injection. We had no cases of wipe-out syndrome.
Conclusion: Our study shows the effectiveness of this special phacotrabeculectomy technique on IOP control and visual acuity improvement, with low complication incidence compared to classical phacotrabeculectomies.