Comparative results of combined procedures for glaucoma and cataract: II. Limbus-based versus fornix-based conjunctival flaps

Gülgün Tezel, Allan E. Kolker, Michael A. Kass, Martin B. Wax

Research output: Contribution to journalArticle

41 Citations (Scopus)

Abstract

BACKGROUND AND OBJECTIVE: One of the variables to be considered in a combined procedure for glaucoma and cataract is the type of conjunctival flap to be used. The objective of this study was to compare the effects of limbus- based and fornix-based conjunctival flaps on postoperative long-term intraocular pressure (IOP) control and visual acuity after combined trabeculectomy with phacoemulsification. PATIENTS AND METHODS: The authors retrospectively reviewed the charts of 189 patients (215 eyes) who underwent combined trabeculectomy with phacoemulsification, posterior chamber intraocular lens (IOL) implantation, and intraoperative mitomycin-C administration and who had a minimum follow-up of 12 months. The results of the limbus-based (151 eyes) versus fornix-based (64 eyes) conjunctival incisions used in these combined procedures were compared. RESULTS: In the limbus-based conjunctival flap group, 146 eyes (97%) achieved an IOP of less than 20 mm Hg, with or without medication; 62 eyes(97%) of the fornix-based conjunctival flap group (P > .05) achieved this result. A visual acuity of 20/40 or better was noted in 106 eyes (70%) in the limbus-based conjunctival flap group and in 45 eyes (70%) in the fornix-based conjunctival flap group (P > .05) at the last examination. Early wound leakage was observed more frequently in the fornix-based conjunctival flap group (8% vs 1%) (P= .014); however, it was not a serious clinical problem, as only 1 eye required surgical repair. Posterior capsular opacification was found more often in the limbus-based conjunctival flap group (25% vs 14%) (P = .072) and required more frequent laser capsulotomy (22% vs 9%) (P = 0.03). CONCLUSION: Limbus- based and fornix-based conjunctival flaps appear to be comparable with respect to postoperative IOP control and visual acuity after a combined trabeculectomy with phacoemulsification and posterior chamber IOL implantation in cases supplemented by intraoperative mitomycin-C.

Original languageEnglish (US)
Pages (from-to)551-557
Number of pages7
JournalOphthalmic Surgery and Lasers
Volume28
Issue number7
StatePublished - Jul 1997

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Glaucoma
Cataract
Trabeculectomy
Phacoemulsification
Intraocular Pressure
Visual Acuity
Intraocular Lens Implantation
Mitomycin
Lasers
Wounds and Injuries

ASJC Scopus subject areas

  • Ophthalmology

Cite this

Comparative results of combined procedures for glaucoma and cataract : II. Limbus-based versus fornix-based conjunctival flaps. / Tezel, Gülgün; Kolker, Allan E.; Kass, Michael A.; Wax, Martin B.

In: Ophthalmic Surgery and Lasers, Vol. 28, No. 7, 07.1997, p. 551-557.

Research output: Contribution to journalArticle

Tezel, Gülgün ; Kolker, Allan E. ; Kass, Michael A. ; Wax, Martin B. / Comparative results of combined procedures for glaucoma and cataract : II. Limbus-based versus fornix-based conjunctival flaps. In: Ophthalmic Surgery and Lasers. 1997 ; Vol. 28, No. 7. pp. 551-557.
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abstract = "BACKGROUND AND OBJECTIVE: One of the variables to be considered in a combined procedure for glaucoma and cataract is the type of conjunctival flap to be used. The objective of this study was to compare the effects of limbus- based and fornix-based conjunctival flaps on postoperative long-term intraocular pressure (IOP) control and visual acuity after combined trabeculectomy with phacoemulsification. PATIENTS AND METHODS: The authors retrospectively reviewed the charts of 189 patients (215 eyes) who underwent combined trabeculectomy with phacoemulsification, posterior chamber intraocular lens (IOL) implantation, and intraoperative mitomycin-C administration and who had a minimum follow-up of 12 months. The results of the limbus-based (151 eyes) versus fornix-based (64 eyes) conjunctival incisions used in these combined procedures were compared. RESULTS: In the limbus-based conjunctival flap group, 146 eyes (97{\%}) achieved an IOP of less than 20 mm Hg, with or without medication; 62 eyes(97{\%}) of the fornix-based conjunctival flap group (P > .05) achieved this result. A visual acuity of 20/40 or better was noted in 106 eyes (70{\%}) in the limbus-based conjunctival flap group and in 45 eyes (70{\%}) in the fornix-based conjunctival flap group (P > .05) at the last examination. Early wound leakage was observed more frequently in the fornix-based conjunctival flap group (8{\%} vs 1{\%}) (P= .014); however, it was not a serious clinical problem, as only 1 eye required surgical repair. Posterior capsular opacification was found more often in the limbus-based conjunctival flap group (25{\%} vs 14{\%}) (P = .072) and required more frequent laser capsulotomy (22{\%} vs 9{\%}) (P = 0.03). CONCLUSION: Limbus- based and fornix-based conjunctival flaps appear to be comparable with respect to postoperative IOP control and visual acuity after a combined trabeculectomy with phacoemulsification and posterior chamber IOL implantation in cases supplemented by intraoperative mitomycin-C.",
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