To deliberately include a flap of anterior lens capsule in the trabeculectomy site to determine whether it aids filtration in a glaucoma bleb.
El-Maghraby Eye Hospital, Jeddah, Saudi Arabia.
The study comprised 23 consecutive patients (25 eyes) with dense cataract and uncontrolled glaucoma despite maximum medical therapy. Combined trabeculectomy, planned extracapsular cataract extraction, posterior chamber intraocular lens implantation, and inclusion of the anterior lens capsule under the trabeculectomy scleral flap were performed. Follow-up ranged from 6 to 72 months.
All eyes had improved visual acuity mainly because of cataract removal. Best spectacle-corrected visual acuity in 20 eyes ranged from 20/40 to 20/20. A diffuse filtration bleb was achieved in most cases. Postoperative intraocular pressure (IOP) was 20 mm Hg or less in 80% of eyes. Five eyes required additional topical timolol therapy. None required additional carbonic anhydrase inhibitor therapy.
The combined procedure appeared to be a sound method of providing visual rehabilitation and adequate IOP control. The use of the capsular wick seemed to help maintain glaucoma filtration.