Efficacy of drainage implants in combined cataract and glaucoma surgery

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The combination of glaucoma and cataract occurs in 14.6—76% of cases, according to various sources. The goal of surgical treatment for these patients is to improve visual function while simultaneously reducing intraocular pressure. Due to the wide variety of proposed surgical methods, there is no consensus on the optimal management strategy for such patients.

PURPOSE

This study evaluates the hypotensive effect and visual function outcomes of combined surgery for complicated cataract and glaucoma using the mesh drain made of digeland the xenocollagen drain.

MATERIAL AND METHODS

Patients in Group 1 (n=43; 48.3%) underwent combined cataract and glaucoma surgery with implantation of the digel drainage implant, while patients in Group 2 (n=46; 51.7%) underwent an identical operation with the xenocollagen implant. Preoperative tonometric pressure was 27.2±1.7 and 27.3±1.9 mm Hg; best corrected visual acuity was 0.35±0.21 and 0.33±0.18, respectively. The following surgical technique was employed. At 3.0—4.0 mm from the limbus, an intrascleral tunnel was created using a 2.2 mm sclerotome through the conjunctiva in the anteroposterior direction, exiting into the anterior chamber. Capsulorhexis and phacoaspiration were performed. The scleral tunnel was widened to 3 mm, and the intraocular lens was implanted. Penetrating basal coloboma of the iris was formed. The deep flap of the scleral tunnel was dissected from the flat part of the ciliary body and removed. The digel implant was shaped into a T-configuration, while the xenocollagen implant was used without modification. Each drainage was implanted into the intrascleral tunnel (one end directed into the anterior chamber, the other exiting the scleral tunnel). The conjunctiva was sutured with 10/0 stitches, and the paracenteses were hydrated.

RESULTS

Over a 24-month follow-up period, the tonometric intraocular pressure in Groups 1 and 2 was 18.8 and 18.5 mm Hg, respectively, and the best corrected visual acuity was 0.51 and 0.58.

CONCLUSION

The use of both drainages in the proposed combined surgery for complicated cataract and glaucoma results in similarly stable hypotensive outcomes and high visual function.

Keywords:

cataract

glaucoma

phacoemulsification

trabeculectomy

drainage implant

intraocular lens

intraocular pressure

Authors:

Ivachev E.A.

Clinical Hospital RZD-Meditsina in Penza;
Penza State University

ORCID: 0000-0001-5662-4195

Kochergin S.A.

Russian Medical Academy of Continuous Professional Edication

ORCID: 0000-0002-8913-822X

Nikitina L.O.

Penza State University

ORCID: 0009-0005-6056-147X

Received:

19.04.2024

Accepted:

30.05.2024

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