Phacotrabeculectomy versus two-stage operation: a matched study.

BACKGROUND AND OBJECTIVE: To evaluate the efficacy and safety of phacoemulsification and foldable intraocular lens, combined with trabeculectomy (phacotrabeculectomy) in patients with coexisting cataract and glaucoma. PATIENTS AND METHODS: A total of 53 consecutive eyes which underwent phacotrabeculectomy and posterior chamber intraocular lens (PCIOL) were matched and compared with 53 eyes that had trabeculectomy followed by phacoemulsification and posterior chamber intraocular lens (mean interval 3.2 month). The 2 groups were first matched by diagnostic group and subsequently for the closest possible match with other successive variables, including age, gender, race and preoperative glaucoma medications. Mean intraocular pressure (IOP) reduction, visual acuity, antiglaucoma medications, and surgical success as well as complications were compared in both groups. RESULTS: Mean IOP reduction was 14.5+/-4.1 mmHg in the two-stage group compared to 15.1+/-3.9 in the phacotrabeculectomy group at 6 months follow-up (P<0.1) and 13.8+/-3.9 and 14.6+/-3.7 respectively at 1 year (P<0.1). Visual acuity and complications were comparable. CONCLUSION: Phacotrabeculectomy provides IOP control statistically comparable to two-stage surgery with earlier visual rehabilitation.

Comparative clinicopathological and bacteriological studies in schistosomiasis mansoni.

FIFTY MALE Egyptian inpatients with active colonic mansoniasis were studied clinicopathologically, endoscopically, radiologically and bacteriologically. This was done to find out the pattern of colonic and urinary enterobacteria and serum antisalmonella agglutinins in various stages of mansoniasis. Cases are divided into three groups (A, B and C) according to the stage of their hepato-splenomegally. Their clinical presentations were dysentery, rectal bleeding, abdominal distension, anaemia, endocrinal changes and general weakness. Oesophageal varices were diagnosed in 19.8% of group C patients. Distal colonic polyps were noticed in 25% and 4% of group A and B cases respectively, while colonic ulcers were found in 20% of patients of either group. The total number of bilharzia ova per gram of fresh colonic biopsy was highest in group A and lowest in group C subjects. Mucosal and submucosal bilharzial granulation tissue formation together with mucosal hypertrophy were conspicuous among group A and B patients. Hematoxylin and eosin stain was of good diagnostic value and the rest of the stains used did not show any fungi or fibrinoid deposits.