TRABECULOTOMY AB EXTERNO, CATARACT-EXTRACTION, AND INTRAOCULAR-LENS IMPLANTATION - PRELIMINARY-REPORT

Purpose: To compare the results of a triple procedure using either ext racapsular cataract extraction (ECCE) or one of two phacoemulsificatio n techniques combined with trabeculotomy ab externo and intraocular le ns (IOL) implantation. Setting: Kyoto University Hospital, Kyoto, Japa n, and Nagata Eye Hospital, Nara, Japan Methods: In this comparative s tudy, 25 eyes with primary open-angle glaucoma had ECCE combined with trabeculotomy ab externo and IOL implantation and 22 had the same proc edure using phacoemulsification instead of ECCE. Of the eyes that had phacoemulsification, 10 had a single-flap and 12 had a double-flap pro cedure. Results: All 22 eyes that had phacoemulsification had a postop erative IOP of 21 mm Hg or less, as did all ECCE eyes except 2. Althou gh the self-sealing incision might have caused the higher incidence of IOP spikes in the immediate postoperative period, IOPs in the phacoem ulsification groups were lower after 3 months. Results were similar in the single-flap and double-flap phacoemulsification groups. There wer e no significant complications. Conclusion: Cataract extraction by pha coemulsification or ECCE combined with]OL implantation and trabeculoto my ab externo is a safe, effective treatment for patients with coexist ing glaucoma and cataract.