Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Comparative Study
. 2005 Jul;243(7):684-8.
doi: 10.1007/s00417-004-1004-x. Epub 2005 Feb 2.

Combined cataract and glaucoma surgery: endoscope-controlled erbium:YAG-laser goniotomy versus trabeculectomy

Heiko Philippin  1 , Sonja Wilmsmeyer, Nicolas Feltgen, Thomas Ness, Jens Funk
Affiliations
Comparative Study

Combined cataract and glaucoma surgery: endoscope-controlled erbium:YAG-laser goniotomy versus trabeculectomy

Heiko Philippin et al. Graefes Arch Clin Exp Ophthalmol. 2005 Jul.

Abstract

Background: To compare endoscopic infrared laser trabecular ablation and trabeculectomy (both combined with cataract surgery) regarding intraocular pressure (IOP), visual acuity, anti-glaucomatous drugs and complications.

Methods: Seventeen eyes of 14 patients [age 74.7+/-11.7 years (arithmetic mean +/- standard deviation)]-13 with primary open-angle glaucoma (POAG) and four with pseudoexfoliation glaucoma (PEXG)-underwent standard cataract surgery. After lens implantation, a probe (1.1 mm external diameter) with optic and laser fibres and an irrigation tube was introduced through the cataract incision. To perforate Schlemm's canal, 15-17 single pulses (16 mJ, 160 micros) were applied using a photo-ablative infrared laser (Er:YAG, lambda=2.94 microm). All eyes except one received antiglaucoma treatment. The control group treated with cataract surgery and trabeculectomy consisted of 17 eyes (13 POAG, four PEXG) of 15 patients (age 75.0+/-5.6 years), each eye received antiglaucoma treatment.

Results: Mean follow-up was 3 years. The eyes treated with the endoscopic laser showed a mean preoperative IOP of 23.3+/-4.3 mmHg, which was reduced to 15.0+/-2.1 mmHg (mean IOP lowering 33.7%) after 3 years. Five eyes needed no medication for IOP-control after the procedure. Two eyes needed further surgery for IOP-control. In the control group, mean IOP was 24.5+/-2.6 mmHg in the beginning and 17.3+/-6.2 mmHg after 3 years, corresponding to a 33.3% lowering of IOP. Six eyes needed no medication, four eyes needed further surgery to lower IOP.

Conclusions: After 3 years follow-up of a small pilot group, combined endoscopic infrared laser surgery with cataract surgery seems to be a safe and effective way to lower IOP. It shows the same ability to lower IOP as combined cataract surgery with trabeculectomy. In addition, there are markedly less complications with the endoscope-controlled photo-ablative laser procedure.

PubMed Disclaimer

References

    1. Ophthalmic Surg Lasers. 2000 Jan-Feb;31(1):49-54 - PubMed
    1. Exp Eye Res. 1997 May;64(5):701-6 - PubMed
    1. Klin Monbl Augenheilkd. 2001 Aug;218(8):535-41 - PubMed
    1. Ophthalmologe. 1996 Oct;93(5):565-8 - PubMed
    1. Ophthalmic Surg Lasers. 2001 Nov-Dec;32(6):483-5 - PubMed

Publication types

Substances

LinkOut - more resources