RESUMO
Purpose: To evaluate the effect of clear corneal phacoemulsification on glaucomatous eyes that has had previously successful filtering surgery
Methods: This study was undertaken in 21 eyes with glaucoma that had phacoemulsification after successful trabeculectomy. The interval between trabeculectomy and phacoemulsification ranged between 15 to 26 months. Only those cases who had IOP <21 mmHg over the preceding 6 months without any medical treatment following trabeculectomy were included in this study. All patients underwent phacoemulsification through a superior clear corneal, three-stepped, 1.5 mm long tunneled incision and in-the-bag PMMA intraocular lens implantation. Surgical difficulties, complications, postoperative intraocular pressure and best corrected visual acuity were studied and analyzed over a follow up of 6 months
Results: Complications seen during the surgery were corneal edema in 5 eyes [23.8%], iris trauma in two eyes [9.5%], tear in the rhexis in two eyes [9.52%], vitreous loss in one eye [4.76%] and early increase in IOP in one eye [4.76%]. Postoperatively, visual acuity improved in all cases. Mean IOP increased after phaco-emulsification by about 1.23 mmHg [preoperatively 14.84+/-2. 73 mm Hg], 6 months postoperatively [16.26+/-1.2 mmHg]. Difference in IOP at all patients during follow up period was found to be statistically insignificant [p>0.05]
Conclusion: Clear corneal phacoemulsification in previously filtered glaucomatous eyes is feasible although difficult. However, with slight modification in the technique, it can be accomplished without sight-threatening complications. In addition, it does not adversely affect the functioning of the bleb
RESUMO
Purpose: to compare the safety and efficacy of trypan blue 0.1 % and gentian violet 0.001% for anterior capsule staining in cases of white cataract
Methods: thirty eyes with age-related white cataract had anterior capsule staining with trypan blue 0.1% [15 eyes], and gentian violet 0.001% [15 eyes], under an air bubble followed by phacoemulsification with posterior chamber intraocular lens [PC IOL] implantation. The ease of creating a continuous curvilinear capsulorhexis [CCC] and intraoperative complications were noted. Postoperative examinations at 1day, 1week and 1month included visual acuity, anterior chamber reaction, and intraocular pressure [IOP] were documented. The mean phaco power and time were also recorded
Results: complete CCC was achieved in 24 eyes [80%], 6 eyes [20%] had extension of the capsulorehexis, thus the surgery was converted to conventional ECCE. All patients had a BCVA worse than 6/60 before surgery. One week after surgery, Twenty-three [76.7%] had a BCVA of 6/9 or better. Five eyes [16.7%] had a BCVA worse than 6/60 postoperatively. Examination of those eyes revealed preexisting posterior segment pathology. Two eyes [6.7%] had increased IOP, with the highest measured at 26mmHg postoperatively. Their BCVA were 6/24. These 2 eyes responded well to medication, and the IOP returned to normal by the second postoperative week. Almost all eyes achieved a BCVA of 6/9 from the first week postoperatively to the last follow-up. The side port and corneal tunnel were stained most intensely with gentian violet than trypan blue groups. All eyes had clear corneas and a quiet anterior chamber 1 month after surgery. The mean phaco power and time were not significantly different between the 2 groups [P=0.367 and P=0.12, respectively]
Conclusion: both trypan blue 0.1% and gentian violet 0.001% are safe and effective for staining and visualization of the anterior capsule during phacoemulsification of white cataract