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  • 1
    ISSN: 1573-2630
    Keywords: combined cataract-glaucoma surgery ; extracapsular cataract surgery ; phacoemulsification ; trabeculectomy
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Purpose: To compare the efficacy and complication rate of two standard cataract extraction techniques with different incision lengths when combined with trabeculectomy. Methods: 54 eyes after combined ECCE, posterior chamber lens implantation and trabeculectomy (ECCE-group) are compared with 49 eyes following phacoemulsification, trabeculectomy and implantation of a folded flexible posterior chamber lens (small-incision group). Minimum follow-up was 24 months. Results: Glaucoma control was achieved in all eyes of both groups. There was a tendency towards a higher number of patients without therapy in the small-incision group (82% versus 65%, p = 0.07). Final mean IOP (14.2 ± 3.0 mmHg versus 15.5 ± 2.7 mmHg, p = 0.02) and mean therapy index (0.2 ± 0.5 versus 0.4 ± 0.6, p = 0.03) were significantly lower in the small-incision group. Postoperative complications such as severe fibrin effusion (41% versus 18%, p = 0.018), early postoperative IOP rises 〉 25 mmHg (18% versus 2%, p = 0.009), filtering bleb scarring (63% versus 8%, p 〈 0.0001) and the total number of complications (87% versus 63%, p = 0.006) were significantly higher in the ECCE-group. Conclusion: With the decrease of the incision size necessary for the cataract extraction a reduction of postoperative complications and better functional results are achieved in combined cataract/glaucoma surgery.
    Type of Medium: Electronic Resource
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  • 2
    Electronic Resource
    Electronic Resource
    Springer
    Documenta ophthalmologica 80 (1992), S. 301-307 
    ISSN: 1573-2622
    Keywords: Carbachol ; intraocular pressure ; polyHema intraocular lens ; small-incision cataract ; surgery ; sodium hyaluronate
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Sixty patients, who underwent phacoemulsification and implantation of a folded polyHema intraocular lens were assigned to two groups. Following wound closure 0.5 ml of 0.01% carbachol or balanced salt solution was instilled into the anterior chamber. Healon was used in all eyes but evacuated from the capsular bag behind the intraocular lens and the anterior chamber. Intraocular pressure was measured the day before as well as 6 and 18 hours postoperatively. At 6 hours the mean change of intraocular pressure from baseline was ±2.8 ± 5.3 mmHg in the carbachol group compared with +4.7 ± 8.0 mmHg in the BSS group (p 〈 0.0001). At 18 hours the mean change from baseline was ±3.0 ± 4.6 mmHg in the treatment group and +2.3 ± 8.5 in the control group (p 〈 0.0001). Intraocular pressure exceeding 25 mmHg at 6 hours was observed in 8 (27%) eyes of the control group but none of the treatment group. At 18 hours 4 (13%) eyes of the control group and 1 (3%) of the carbachol group still had an increase of intraocular pressure. Summarizing our results we conclude that the effect of Healon on the postoperative intraocular pressure is successfully counteracted by its aspiration from the capsular bag and the anterior chamber, especially when carbachol is used for intraoperative miosis.
    Type of Medium: Electronic Resource
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