COMBINED PHACOEMULSIFICATION AND FILTERING SURGERY WITH THE NO-STITCHTECHNIQUE

Objective: To determine if intentionally making a radial incision coul d lead to a lasting decrease in intraocular pressure and the developme nt of filtering blebs. Methods: Forty-three eyes treated with combined filtering surgery were compared with a control group of 42 eyes treat ed with cataract surgery (phacoemulsification) alone. All of the patie nts had advanced chronic open-angle glaucoma. During combined cataract and glaucoma surgery, the tunnel floor was transected with Vannas sci ssors. Results: One year after surgery, the mean intraocular pressure in the study group decreased 7.6 mm Hg from a preoperative mean (+/-SD ) of 25.9+/-5.3 mm Hg. The decrease in the control group was 3.7+/-4.2 mm Hg. The difference between the 2 groups was statistically signific ant (P<.001). In the study group, an average of 1.5+/-0.8 fewer medica tions were required I year after surgery. In the control group, 0.5+/- 0.6 fewer medications were required. Conclusions: The combined surgica l procedure discussed in this article led to a lasting decrease in int raocular pressure. Cataract surgery alone using the no-stitch techniqu e and posterior chamber lens implantation also reduced intraocular pre ssure, although significantly less.