Clinical Comparison between Glaucoma Triple Procedure and Small Incision Cataract Surgery using Foldable silicone IOL

The purpose of this study was to evaluate the postoperative outcomes between the glaucoma triple procedure and the small incision cataract surgery using foldable silicone intraocular lens(IOL). This prospective randomized study comprised of 42 eyes which had the glaucoma triple procedure and 41 eyes which underwent small incision cataract surgery at chonnam University Hospital from May, 1994 to December, 1996. At least 3 months follow-up period was needed. Corrected visual acuity of 0.5 of better was obtained in 50% of triple procedure group and 88% of small incision cataract surgery group with the average lines of improved visual acuity of 5.6 and 7.2 respectively. There was no significant change in the refractive cylinder during the early postoperative period in both group. In the glaucoma triple procedure group, posterior capsular opacification(PCO) developed in significantly low incidence in the Mitomycin C using group and the incidence of PCO in eyes with IOL decentration was greater than in those without IOL decentration. In conclusion, patients who underwent glaucoma triple procedure using foldable silicone IOL showed excellent postoperative IOP control with success rate of 81%, rapid visual rehabilitation and refractive stability. We also found that glaucoma triple procedure with Mitomycin C was associated with lower incidence of PCO.

Clinical Results of Silicone Foldable IOL Implanted Through Small Incision

Small incision cataract surgery has many advantages such as less induced corneal astigmatism, fast visual recovery, and fast rehabilitation. We had implatned the newly developed Staar AA-4203 foldable silicone IOL in the ag of 100 cataractous eye and followed for at least 3 months (3-0 months, mean 6 months). Silicone IOLs were implanted using a specific injector through 4mm scleral pocket incision after continuous circular capsulorhexis and bimanual phacoemulsification. The lenses were centered well in 99% of eyes. Tear of anterior capsule occurred in one eye (1%), and tear of both anterior and posterior cassule occurred in another one eye (1%) during IOL implatation. The IOL was displaced into the vitreous in the latter eye, which was reoperated. The preoperative and postoperative cornedal astigmatism at 1 day, 1 month, 2 month and 3 month was -O.14 +/- 0.83 D of with the rule astigmatism (WTR), -0.55 +/- 1.06 D of WTR, -0.28 +/- 0.91 D of WTR, -0.07 +/- 0.81 D of WTR, and O.01 +/- 0.84 D of against the rule astigmatism respectively. Uncorrected VA of 1.0 was 35% at postoperative 1 day, 52% at 1 month, 48% at 2 month. Corrected VA of 1.0 was 65% at postoperative 1 day, 87% at 1 month, 88% at 2 month. Inflammatory reaction in the anterior chamber and vitreous had subsided within one or two months without any complications in 99% of eyes. Fibrinous membrane on the suface of IOL occurred in 2 eyes (2%), one of which caused grave sequelae. The results, although it showed early postoperative results, reflected that the above silicone foldable IOL fitted to the small incision cataract surgery guaranteed us the safety and fast visual recovery.