A Clinical Evaluation of Combined Trabeculectomy and Intracapsular or Extracapsular Cataract Extraction

Trabeculectomy with intracapsular cataract extraction(Group I) on 14 eyes of 14 patients, and trabeculectomy with extracapsular cataract extraction(Group II) on 17 eyes of 17 patients were perfonned during the period of March 1986 to March 1988. The follow-up periods ranged from 3 monthes to 5 monthes. The mean intraocular pressure was reduced by approximately 54%, from 35 mmHg preoperatively to 16 mmHg postoperatively Group I, and was reduced by approximately 50%, from 34 mmHg preoperatively to 17 mmHg postoperatively in Group II. The visual acuity improved in all cases of both groups. The mean intraocular pressure reduction, operative and postoperative complications, and failure rates were not significantly different between Group I and Group II.

The Effect of Preoperative Subconjunctival Triamcinolone Administration on Glaucoma Filtration

The trabeculectcmies were performed on 12 eyes with uncontrolled glaucoma which had not been treated by the maximum use of tolerated antiglaucoma medication. We assumed that all of these eyes would be at increased risk by episcleral cicatricial closure in the patient with one of the following cases; congenital glaucoma, age of 40 year or less, previously failed glaucoma filtration surgery, aphakia and uveitis. A standard operation was performed except tbat triamcinolone acetonide(4mg) was injected subconjunctivally at the intended trabeculectcmy site one week before surgery in 10 eyes, and cn the day of surgery in 2 eyes. During the followup period of 5 months or more, 11 of 12 eyes had an intraocular pressre(IOP) of 19mmHg or less. The average IOP for these 11 eyes was 14.5 +/- 3.4mmHg(mean +/- SD), and only 2 of the 11 eyes required antiglaucoma medication. One eye was a surgical failure. All eyes with controlled IOP showed micro cystic filtration blebs on slit lamp examination. The postoperative visual acuity was within one line of the preoperative level in all eyes, except for the one surgical failure. The use of triamcinolone acetonide does not seem to have added any additional risks to the postoperative period.

Two Cases of Malignant Melanoma in the Bulbar Conjunctiva

Two cases of malignant melanoma which are located in the bulbar conjunctiva are presented. A case of 56 years old male revealed melanosis in his medial palpebral conjunctiva and wedge shaped resection was performed. The other case of 76 years old male had dark brownish strawberry like pedunclated mass in his lateral bulbar conjunctiva and limbal area with history of progressive enlargement. This tumor mass was excised radically. Above two cases were confirmed as malignant melanoma histopathologically.