Acta Scientific Ophthalmology (ISSN: 2582-3191)

Research Article Volume 5 Issue 1

Results of Combined Small Incision Cataract Surgery and Cyclodialysis in Low Income Patients with Glaucoma and Cataract

Mario Renato Papa-Vettorazzi1*, Claudia María Lopez-Villeda1, José Benjamín Cruz-Rordriguez2, Gladys Lucía Silva-Linares1 and Mariano Yee-Melgar1

1Visualiza Clinic, 5ta av. 11-44 Zona 9, Guatemala, Guatemala
2University of California, San Diego, CA, USA

*Corresponding Author: Mario Renato Papa-Vettorazzi, Visualiza Clinic, 5ta av. 11-44 Zona 9, Guatemala, Guatemala.

Received: August 16, 2021; Published: December 14, 2021

Abstract

Purpose: To assess the short and long term effect of combined cataract and glaucoma surgery (Small Incision Cataract Surgery [SICS] plus cyclodialysis) in a low income population.

Study design: Retrospective.

Materials and methods: We performed a retrospective analysis of 355 SICS plus cyclodialysis procedures all performed by experienced surgeons. Evaluations at day one, 1 week, 1, 3, 6 and 12 months. At every visit, the evaluation included: intra ocular pressure (IOP) measurement, glaucoma medication requirements and corrected distance visual acuity (CDVA). We also evaluated complications and re interventions.

Results: The median preoperative IOP was 18 mmHg (15-24), it decreased to 12 mmHg (10-14) at the 7 days, 1, 3, 6 and 12 month assessments (p < 0.01). Mean number of glaucoma medications decreased from 1.55 preoperatively to 0.96 postoperatively (mean decrease 0.58, 95% CI-0.84 to -0.32, p < 0.01). At three months median CDVA improved from 0.69 logMar (0.47-1.8) (20/100 Snellen) to 0.3 logMar (0.17-0.51) (20/40 Snellen) (p < 0.01). Complication rate was 9%, the most frequent was posterior capsule rupture (PCR). Re intervention rate was 10% mostly because of not achieving IOP control.

Conclusions: Combining SICS plus cyclodialysis is effective, it shows a short and long term reduction in IOP, a decrease in glaucoma medication requirements and an improvement in CDVA all comparable to the reports of phacoemulsification plus trabeculectomy.

Keywords: Combined Surgery; Cyclodialysis; Glaucoma Surgery; SICS

References

  1. Bourne Rupert R A., et al. “Causes of vision loss worldwide, 1990-2010: a systematic analysis”. The Lancet Global Health6 (2013): e339-349.
  2. European Glaucoma Society Terminology and Guidelines for Glaucoma, 4th Edition (2017): 131-191.
  3. Shields M B and R J Simmons. “Combined cyclodialysis and cataract extraction”. Ophthalmic Surgery2 (1976): 62-73.
  4. Rowan P J. “Combined cyclodialysis and cataract surgery”. Ophthalmic Surgery and Lasers12 (1998): 962-968.
  5. Hansen S and A B Laursen. “Visualized cyclodialysis--an additional option in glaucoma surgery”. Acta Ophthalmologica2 (1986): 142-145.
  6. Rotchford Alan P and Anthony J King. “Moving the goal posts definitions of success after glaucoma surgery and their effect on reported outcome”. Ophthalmology1 (2010): 18-23.e3.
  7. The Advanced Glaucoma Intervention Study (AGIS): 7. The relationship between control of intraocular pressure and visual field deterioration. The AGIS Investigators. American Journal of ophthalmology4 (2000): 429-440.
  8. Sanidad MDE and Igualdad SSE. Guía de Práctica Clínica Sobre Glaucoma de Ángulo Abierto. Catalunya (2017).
  9. Urcelay JL., et al. “Trabeculectomía”. Ann d’Oftalmología 4 (2015): 52-60.
  10. Yee MM. Terapias alternativas para el tratamiento del Glaucoma | VISIÓN (2020).
  11. Mamalis N., et al. “Combined phacoemulsification, intraocular lens implantation, and trabeculectomy”. Journal of Cataract and Refractive Surgery4 (1996): 467-473.
  12. Shingleton Bradford J., et al. “Combined cataract and trabeculectomy surgery in eyes with pseudoexfoliation glaucoma”. Journal of Cataract and Refractive Surgery 11 (2011): 1961-1970.
  13. Jiang Nan., et al. “Meta-analysis of the efficacy and safety of combined surgery in the management of eyes with coexisting cataract and open angle glaucoma”. International Journal of Ophthalmology2 279-286.
  14. Ting Jessica L M., et al. “Ab interno trabeculectomy: outcomes in exfoliation versus primary open-angle glaucoma”. Journal of Cataract and Refractive Surgery2 (2012): 315-323.
  15. Ruderman J M., et al. “Combined phacoemulsification and trabeculectomy with mitomycin-C”. Journal of Cataract and Refractive Surgery8 (1996): 1085-1090.
  16. Stark W J., et al. “The safety and efficacy of combined phacoemulsification and trabeculectomy with releasable sutures”. The British Journal of Ophthalmology2 (2006): 146-149.

Citation

Citation: Mario Renato Papa-Vettorazzi., et al. “Results of Combined Small Incision Cataract Surgery and Cyclodialysis in Low Income Patients with Glaucoma and Cataract".Acta Scientific Ophthalmology 5.1 (2022): 04-12.

Copyright

Copyright: © 2022 Mario Renato Papa-Vettorazzi., et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.




Metrics

Acceptance rate35%
Acceptance to publication20-30 days
ISI- IF1.042
JCR- IF0.24

Indexed In




News and Events


  • Certification for Review
    Acta Scientific certifies the Editors/reviewers for their review done towards the assigned articles of the respective journals.
  • Submission Timeline for Upcoming Issue
    The last date for submission of articles for regular Issues is December 25, 2024.
  • Publication Certificate
    Authors will be issued a "Publication Certificate" as a mark of appreciation for publishing their work.
  • Best Article of the Issue
    The Editors will elect one Best Article after each issue release. The authors of this article will be provided with a certificate of "Best Article of the Issue"

Contact US