Outcome of combined cataract extraction and trabeculectomy with mitomycin c performed by fellows

• Main Authors: Archana Singaram, Premanand Chandran, Varsha Ramachandra, Vinoth Arunaachalam, Vishwaraj Ramaswamy, Ganesh V Raman
• Format: Article
• Language: English
• Published: Wolters Kluwer Medknow Publications 2017-01-01
• Series: TNOA Journal of Ophthalmic Science and Research
• Subjects: combined glaucoma surgery; fellows' surgery; trabeculectomy
• Online Access: http://www.tnoajosr.com/article.asp?issn=2589-4528;year=2017;volume=55;issue=4;spage=273;epage=277;aulast=Singaram
• ISSN: 2589-4528; 2589-4536

Aim: This study was aimed to report the outcome of combined cataract extraction and trabeculectomy with mitomycin C performed by fellows at a tertiary eye care center in South India. Materials and Methods: A retrospective review of patients who underwent combined cataract extraction, intraocular lens implantation, and trabeculectomy with mitomycin C performed by fellows between January and December 2015. Patients diagnosed with primary open-angle glaucoma, primary angle-closure glaucoma, and pseudoexfoliation glaucoma were included and those with normal tension, lens-induced, neovascular glaucoma and previous failed glaucoma-filtering surgery were excluded. Results: The study included 280 patients (282 eyes) with a mean age ± standard deviation of 67.9 ± 7.9 years. Mean intraocular pressure (IOP) reduced from a preoperative value of 21.1 ± 6.7 mmHg to 14.2 ± 3.6 and 15.3 ± 4.8 mmHg (P < 0.001) at 6 months and 1 year, respectively. Mean number of antiglaucoma medications reduced from 1.4 ± 0.7 to 0.1 ± 0.1 and 0.1 ± 0.3 (P < 0.001) at 6 months and 1 year, respectively. Mean best-corrected visual acuity improved from 6/60 to 6/12 (P < 0.001) postoperatively. Complete success was 97% at 6 months and 92% at 1 year and qualified success was 100% at 6 months and 1 year. Three patients failed during the follow-up period. The intraoperative complication rate was 7% and reoperation rate was 4.6%. Conclusion: Combined cataract extraction and trabeculectomy performed by fellows is safe and effective to restore vision and control IOP in patients with coexisting cataract and glaucoma.